Alonso M J, Yebra M, Pereira F, San Juan I, Nieto J, Ruiz J, Berrocal E
Centro Nacional de Investigaciones Médico-Quirúrgicas, Clínica Puerta de Hierro, Universidad Autónoma, Madrid.
Rev Esp Enferm Dig. 1994 Apr;85(4):277-80.
Autoimmune hemolytic anemia is a rare, although not exceptional, complication of ulcerative colitis. This report presents a case of this association, which is noteworthy in that the hematologic picture appeared immediately after colectomy was performed due to colonic perforation. The features of the only three reported cases in which anemia developed after colectomy are reviewed, and the role of this surgical technique in the treatment of hemolytic anemia associated with ulcerative colitis is discussed. Although colectomy does not protect patients with ulcerative colitis from the onset of hemolytic anemia, we consider that proctocolectomy should be included among the therapeutic alternatives when this association is present, especially in the case of refractory colitis.
自身免疫性溶血性贫血是溃疡性结肠炎一种罕见但并非罕见的并发症。本报告呈现了这样一例关联病例,值得注意的是,由于结肠穿孔进行结肠切除术后立即出现了血液学表现。回顾了仅有的三例结肠切除术后发生贫血的报道病例的特征,并讨论了该手术技术在治疗与溃疡性结肠炎相关的溶血性贫血中的作用。尽管结肠切除术不能保护溃疡性结肠炎患者免于溶血性贫血的发生,但我们认为,当存在这种关联时,尤其是在难治性结肠炎的情况下,全结肠直肠切除术应作为治疗选择之一。