Osawa H, Otsuka T, Inoue T, Sumida I, Hanada M, Okamura T, Nakazato S
Internal Medicine, Karatsu Red Cross Hospital, Saga, Japan.
Rinsho Ketsueki. 1993 Feb;34(2):165-70.
A 65 year-old woman was admitted in May 1990, because of fever, generalized lymphadenopathy and eruption. Laboratory examination showed granulocytopenia, polyclonal hypergammaglobulinemia, positive Coombs' test, positive cold antibody and positive anti-E erythrocyte antibody. 7 days after admission autoimmune hemolytic anemia developed. The appearance of the anti neutrophil leukocyte antibody was suspected because of the absence of the segmented neutrophils in marrow specimen. Histological findings of the biopsied lymph node and the marker study of the tumor cell disclosed IBL-like T cell lymphoma. The patient was treated with G-CSF and VEPA chemotherapy. Granulocytes increased and she showed marked symptomatic improvement with complete remission. Our case showed various clinical pictures with hemolytic anemia and granulocytopenia, which could be based on the autoimmune mechanisms.
一名65岁女性于1990年5月入院，原因是发热、全身淋巴结肿大和皮疹。实验室检查显示粒细胞减少、多克隆高球蛋白血症、库姆斯试验阳性、冷抗体阳性和抗-E红细胞抗体阳性。入院7天后发生了自身免疫性溶血性贫血。由于骨髓标本中缺乏分叶核中性粒细胞，怀疑抗中性粒细胞抗体出现。活检淋巴结的组织学检查结果和肿瘤细胞的标志物研究显示为IBL样T细胞淋巴瘤。该患者接受了粒细胞集落刺激因子（G-CSF）和VEPA化疗。粒细胞增多，她的症状明显改善并完全缓解。我们的病例表现出伴有溶血性贫血和粒细胞减少的各种临床症状，这可能基于自身免疫机制。
