Azuma E, Nishihara H, Hanada M, Nagai M, Hiratake S, Komada Y, Sakurai M
Department of Pediatrics and Clinical Immunology, Mie University School of Medicine, Japan.
Bone Marrow Transplant. 1996 Jul;18(1):243-6.
A 10-year-old male with severe aplastic anemia following allogeneic BMT developed a hemolytic crisis on post-BMT day 67. The diagnosis of cold hemagglutinin disease was made based on the findings of anemia, reticulocytosis, positive direct Coombs test, and markedly elevated cold agglutinins. Anti-nuclear antibody and anti-DNA antibody were also increased. Plasmapheresis was effective as an emergency measure. Corticosteroid after plasmapheresis had a transient effect. At the second episode of hemolysis 6 months after BMT, immunosuppressive therapy with cyclophosphamide plus corticosteroid was successfully administered without negative effect on engraftment.
一名10岁男性在接受异基因骨髓移植后发生严重再生障碍性贫血，于移植后第67天出现溶血危象。根据贫血、网织红细胞增多、直接抗人球蛋白试验阳性及冷凝集素显著升高的检查结果，诊断为冷凝集素病。抗核抗体和抗DNA抗体也升高。血浆置换作为紧急措施有效。血浆置换后使用皮质类固醇有短暂疗效。在骨髓移植6个月后的第二次溶血发作时，成功给予环磷酰胺加皮质类固醇的免疫抑制治疗，且对植入无负面影响。
