Salmon C
Ann Immunol (Paris). 1977 Jan-Mar;128(1-2):521-9.
Acquired hemolytic anemia (AHA) can be considered under four aspects: 1) The nature and specificity of involved autoantibodies correspond to weakly differentiated structures of high frequency but normal human blood group antigens. 2) The pathologic role of autoantibody can be experimentally demonstrated by parallel measures of the specific red cell survival. 3) In certain cases of AHA--secondary to infections (Mycoplasma pneumoniae, infectious mononucleosis) or drugs (methyl dopa), or related to tumours (dermoid ovarian cyste, ovary teratoma) or tissue damages (haemorragic rectocolitis)--the relation between a clinical precise circumstance and the production of autoantibody can actually be demonstrated. 4) In idiopathic AHA, in addition to various autoantibodies, an immunological disorder is observed, including the production of allo- and heteroantibodies and, in 50% of the cases, a global deficit in immunoglobulin. 5) On these bases, the nature of autoimmunity is discussed. If specific modifications can explain secondary AHA, they can hardly account for idiopathic AHA. Cellular non-specific anomalies should be considered.
获得性溶血性贫血(AHA)可从以下四个方面来考虑:1)所涉及自身抗体的性质和特异性与高频但正常的人类血型抗原的低分化结构相对应。2)自身抗体的病理作用可通过特定红细胞存活的平行测量实验性地证明。3)在某些AHA病例中——继发于感染(肺炎支原体、传染性单核细胞增多症)或药物(甲基多巴),或与肿瘤(皮样卵巢囊肿、卵巢畸胎瘤)或组织损伤(出血性直肠结肠炎)相关——临床确切情况与自身抗体产生之间的关系实际上可以得到证明。4)在特发性AHA中,除了各种自身抗体外,还观察到一种免疫紊乱,包括同种抗体和异种抗体的产生,并且在50%的病例中存在免疫球蛋白整体缺乏。5)基于这些情况,对自身免疫的性质进行了讨论。如果特定的改变可以解释继发性AHA,那么它们很难解释特发性AHA。应考虑细胞非特异性异常。