血管免疫母细胞性淋巴结病患者的血浆置换。临床和免疫异常的改善。
Plasmapheresis in a patient with angioimmunoblastic lymphadenopathy. Improvement in clinical and immunologic abnormalities.
作者信息
Gordon B R, Suthanthiran M, Saal S D, Stenzel K H, Rubin A L
出版信息
Cancer. 1983 Mar 1;51(5):829-33. doi: 10.1002/1097-0142(19830301)51:5<829::aid-cncr2820510514>3.0.co;2-p.
A patient with steroid resistant, allergen related angioimmunoblastic lymphadenopathy underwent a course of six plasmaphereses during a three-week period. A 75% reduction in lymph node size along with the disappearance of her night sweats occurred. Immunologic abnormalities prior to plasmapheresis included the presence of elevated levels of circulating immune complexes, high levels of spontaneous mononuclear cell blastogenesis and abnormal mitogen responses to Conconavalin A and phytohemagglutinin. Following plasmapheresis there was a marked reduction in immune complex levels, and return of spontaneous blastogenesis and mitogen responses to normal levels. Mechanisms for the beneficial effect seen in this patient include removal of: (1) the antigenic stimulus; (2) antigen antibody complexes; and (3) other humoral factors which may modulate lymphocyte or macrophage function. Additional studies of plasmapheresis are warranted in selected patients with allergen related AIL.
一名患有类固醇抵抗性、变应原相关血管免疫母细胞性淋巴结病的患者在三周内接受了六个疗程的血浆置换。淋巴结大小缩小了75%，同时盗汗消失。血浆置换前的免疫异常包括循环免疫复合物水平升高、自发单核细胞增殖水平高以及对刀豆球蛋白A和植物血凝素的丝裂原反应异常。血浆置换后，免疫复合物水平显著降低，自发增殖和丝裂原反应恢复到正常水平。该患者所见有益效果的机制包括清除：(1)抗原刺激物；(2)抗原抗体复合物；(3)其他可能调节淋巴细胞或巨噬细胞功能的体液因子。对于选定的变应原相关AIL患者，有必要对血浆置换进行进一步研究。
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