Panzarino V, Estrada J, Benson K, Postoway N, Garratty G
Department of Pediatrics, University of South Florida, Tampa.
Int J Hematol. 1993 Jun;57(3):259-63.
A 2-year-old male presented with upper respiratory tract infection symptoms, continuous high fever, extensive truncal rash with desquamation, lymphadenopathy, subconjunctival hemorrhage, and oral stomatitis. He was diagnosed with Kawasaki disease and did well on aspirin. Approximately 8 weeks after initial presentation he had evidence of severe immune hemolysis. At that time a direct antiglobulin test was microscopically positive; it became strongly positive (3 + IgG, w + C3) 2 weeks later. The serology was unusual in that a warm IgG autoantibody and a low titer high thermal range cold antibody of unusual specificity (anti-Ena or anti-Pr) were present. We were uncertain as to which antibody caused the hemolysis, or whether they worked synergistically. The hemolysis resolved following treatment with high dose prednisone.
一名2岁男性出现上呼吸道感染症状、持续高热、躯干广泛皮疹伴脱屑、淋巴结病、结膜下出血和口腔炎。他被诊断为川崎病，服用阿司匹林后情况良好。初次就诊约8周后，他出现严重免疫性溶血的证据。当时直接抗球蛋白试验镜检呈阳性；2周后变为强阳性（3+IgG，w+C3）。血清学检查结果不寻常，因为存在一种温IgG自身抗体和一种低滴度、高热范围、特异性异常的冷抗体（抗-Ena或抗-Pr）。我们不确定是哪种抗体导致了溶血，还是它们协同起作用。高剂量泼尼松治疗后溶血症状消退。
