Niitsu N, Nakayama M, Kato M, Umeda M
First Department of Internal Medicine, Toho University School of Medicine.
Rinsho Ketsueki. 1997 Jul;38(7):587-92.
Autoimmune hemolytic anemia (AIHA) complicated with non-Hodgkin's lymphoma (NHL) is not unusual. Two cases of NHL associated with cold agglutinin disease were reported. Case 1: A 38-year-old man had diffuse medium-sized cell NHL diagnosed by cervical lymph node biopsy. The Hb was 7.6 g/dl with a cold agglutinin titer of 32,768, and the IgM level was 890 mg/dl (I-specific), so cold agglutinin disease (CAD) was suspected. After administration of COP-BLAM therapy, complete remission (CR) was achieved along with a decrease in the cold agglutinin titer and improvement of anemia. Case 2: A 68-year-old woman had follicular mixed NHL diagnosed by inguinal lymph node biopsy. The Hb was 8.2 g/dl with a cold agglutinin titer of 51,200, and an IgM level of 920 mg/dl (I specific), thus concurrent CAD was suspected. Biweekly COP-BLAM therapy was administered and CR was achieved along with a decrease in the cold agglutinin titer and improvement of her anemia. In both patients, the cold agglutinin titer decreased after CR was achieved suggesting that production of anti-erythrocyte autoantibody was due to disturbance of the antibody system by NHL.
自身免疫性溶血性贫血（AIHA）合并非霍奇金淋巴瘤（NHL）并不罕见。本文报告了2例与冷凝集素病相关的NHL。病例1：一名38岁男性经颈部淋巴结活检诊断为弥漫性中等大小细胞NHL。血红蛋白（Hb）为7.6 g/dl，冷凝集素效价为32,768，IgM水平为890 mg/dl（I特异性），因此怀疑为冷凝集素病（CAD）。给予COP-BLAM治疗后，实现完全缓解（CR），同时冷凝集素效价降低，贫血改善。病例2：一名68岁女性经腹股沟淋巴结活检诊断为滤泡性混合性NHL。Hb为8.2 g/dl，冷凝集素效价为51,200，IgM水平为920 mg/dl（I特异性），因此怀疑并发CAD。每两周给予COP-BLAM治疗，实现CR，同时冷凝集素效价降低，贫血改善。在这两名患者中，实现CR后冷凝集素效价均降低，提示抗红细胞自身抗体的产生是由于NHL干扰了抗体系统。
