Lindström F D, Ståhl-Furenhed B
Scand J Infect Dis. 1981;13(3):233-5. doi: 10.3109/inf.1981.13.issue-3.12.
Although a positive direct Coombs' test is common in patients with Mycoplasma pneumoniae infection, manifest haemolysis is rare. A case is presented in which M. pneumoniae infection was followed by severe autoimmune haemolytic anaemia with intravascular haemolysis and haemoglobinuria. The presence of cold haemagglutinins suggests that these autoantibodies caused the haemolysis. Corticosteroid treatment corrected the haemolysis, which was of brief duration. Published data indicate that the mycoplasma agent is capable of altering the I-receptors of normal erythrocytes by haemadsorption and production of a soluble haemolysin.
虽然直接抗人球蛋白试验阳性在肺炎支原体感染患者中很常见，但明显的溶血却很少见。本文报告一例，该患者在肺炎支原体感染后发生了严重的自身免疫性溶血性贫血，伴有血管内溶血和血红蛋白尿。冷凝集素的存在提示这些自身抗体导致了溶血。皮质类固醇治疗纠正了持续时间较短的溶血。已发表的数据表明，支原体病原体能够通过血细胞吸附和产生可溶性溶血素来改变正常红细胞的I型受体。
