Hsu B, Udden M M, Lynch E C
Department of Medicine, Baylor College of Medicine, Houston, Texas, USA.
Am J Med Sci. 1997 Jul;314(1):41-3. doi: 10.1097/00000441-199707000-00009.
Autoimmune hemolytic anemia and adrenal insufficiency are rarely associated with the antiphospholipid antibody syndrome. A 49-year-old woman with a history of deep venous thrombosis and recurrent miscarriages was found to have active autoimmune hemolytic anemia after being admitted to the hospital for cholelithiasis. The patient was treated with corticosteroids and underwent laparoscopic cholecystectomy 1 month later. Two weeks after surgery she had acute adrenal insufficiency. Activated partial thromboplastin time was prolonged, and antiphospholipid antibodies were detected in significant titer. Her illness responded well to corticosteroid therapy. Her direct Coombs' test remained positive. It appears that the antiphospholipid antibody syndrome contributed to the development of venous thrombosis, recurrent miscarriages, autoimmune hemolytic anemia, adrenal insufficiency, and indirectly, pigment stone cholelithiasis in this patient.
自身免疫性溶血性贫血和肾上腺功能不全很少与抗磷脂抗体综合征相关。一名有深静脉血栓形成和反复流产病史的49岁女性，因胆结石入院后被发现患有活动性自身免疫性溶血性贫血。该患者接受了皮质类固醇治疗，并于1个月后接受了腹腔镜胆囊切除术。术后两周，她出现了急性肾上腺功能不全。活化部分凝血活酶时间延长，检测到抗磷脂抗体呈显著滴度。她的病情对皮质类固醇治疗反应良好。她的直接抗人球蛋白试验仍为阳性。看来抗磷脂抗体综合征促成了该患者静脉血栓形成、反复流产、自身免疫性溶血性贫血、肾上腺功能不全的发生，并且间接导致了色素性胆结石。
