Katayama T, Naitou Y, Kusaka M, Ochiai S, Yoshida M, Kaito K, Masuoka H, Shimada T, Nishiwaki K, Kobayashi M
Department of General Internal Medicine, Kashiwa Hospital, Jikei University School of Medicine.
Rinsho Ketsueki. 1995 Apr;36(4):339-46.
A case with autoimmune hemolytic anemia (AIHA) induced by interferon-alpha (IFN-alpha) is presented. A 40-year-old male who had a previous history of autoimmune hemolytic anemia, agranulocytosis and thrombocytopenia was admitted to our hospital because of chronic C type hepatitis. Liver biopsy was performed, which diagnosed chronic active hepatitis and IFN-alpha was administrated at a dose of 3 Meg unit per day. 11 days after the initiation of the therapy he developed hemolytic anemia, but Coombs tests were negative. Although IFN was withdrawn 15 days later, anemia became progressively more serious. 20 days later, both direct and indirect Coombs tests became positive. He was diagnosed as AIHA and treated with methylprednisolone pulse therapy, then he recovered soon afterward. Further analysis of Coombs tests revealed that he had both cold type and warm type (IgG) autoantibodies which was the same type of antibodies for AIHA he suffered 10 years ago. In conclusion, latent AIHA may be reactivated by the treatment with IFN-alpha.
本文报告1例由α干扰素（IFN-α）诱发的自身免疫性溶血性贫血（AIHA）。一名40岁男性，既往有自身免疫性溶血性贫血、粒细胞缺乏症和血小板减少症病史，因慢性丙型肝炎入住我院。进行了肝活检，诊断为慢性活动性肝炎，并给予IFN-α治疗，剂量为每日3百万单位。治疗开始11天后，他出现了溶血性贫血，但库姆斯试验呈阴性。尽管15天后停用了IFN，但贫血逐渐加重。20天后，直接和间接库姆斯试验均呈阳性。他被诊断为AIHA，并接受了甲泼尼龙冲击治疗，随后很快康复。对库姆斯试验的进一步分析显示，他同时具有冷型和温型（IgG）自身抗体，这与他10年前患的AIHA抗体类型相同。总之，潜伏性AIHA可能会被IFN-α治疗重新激活。
