Yasuda N, Kohda M, Nomura M, Nagashima K, Takemura G, Takatsu H, Minatoguchi S, Gotoh K, Fujiwara H
Second Department of Internal Medicine, Gifu University School of Medicine.
Nihon Kyobu Shikkan Gakkai Zasshi. 1996 Aug;34(8):931-6.
A 65-year-old woman was admitted to our hospital because of severe anemia. A skin biopsy was done in January 1994 and sarcoidosis was diagnosed. Diffuse reticular shadows were seen in both lung fields on a chest X-ray film and mediastinal lymph node swelling was seen on a chest CT scan. She was followed as an outpatient and was not treated. She suddenly experienced vertigo and general fatigue in March 1995. Laboratory findings on admission were as follows: Hb 6.2 g/dl, MCV 115.9 fl, Ret 198%, LDH 732 IU/L, I-Bil 1.9 mg/dl, and Coombs' test was positive. Autoimmune hemolytic anemia was diagnosed, and she was treated with prednisolone (1 mg/kg). As of the time of this writing, she has no relapse of hemolytic anemia though prednisolone was discontinued 6 months ago.
一名65岁女性因严重贫血入住我院。1994年1月进行了皮肤活检,诊断为结节病。胸部X线片显示双肺野弥漫性网状阴影,胸部CT扫描显示纵隔淋巴结肿大。她作为门诊患者接受随访,未接受治疗。1995年3月,她突然出现眩晕和全身乏力。入院时实验室检查结果如下:血红蛋白6.2 g/dl,平均红细胞体积115.9 fl,网织红细胞198%,乳酸脱氢酶732 IU/L,间接胆红素1.9 mg/dl,库姆斯试验阳性。诊断为自身免疫性溶血性贫血,给予泼尼松龙(1 mg/kg)治疗。截至撰写本文时,尽管泼尼松龙6个月前已停用,但她的溶血性贫血未复发。