Ghidini A, Korker V L
Perinatal Diagnostic Center, Alexandria Hospital, Virginia, USA.
J Reprod Med. 1998 Aug;43(8):713-5.
Pyruvate kinase deficiency is a rare cause of hemolytic anemia and, in its most severe form, requires splenectomy in childhood. During pregnancy, severe cases have been traditionally managed with prophylactic blood transfusions to keep the hemoglobin concentration above arbitrary thresholds of 7-8 g/dL.
A case of severe pyruvate kinase deficiency anemia was managed conservatively without blood transfusions even though the hemoglobin concentration reached a nadir of 6.8 g/dL. The perinatal outcome was good.
In cases of severe pyruvate kinase deficiency anemia, pregnancy per se might not be an indication for prophylactic blood transfusions.
丙酮酸激酶缺乏症是溶血性贫血的罕见病因,最严重的形式在儿童期需要进行脾切除术。在怀孕期间,传统上对严重病例采用预防性输血治疗,以使血红蛋白浓度保持在7 - 8 g/dL的任意阈值以上。
一例严重丙酮酸激酶缺乏症贫血患者,尽管血红蛋白浓度降至最低点6.8 g/dL,但仍未进行输血而采取保守治疗。围产期结局良好。
对于严重丙酮酸激酶缺乏症贫血病例,妊娠本身可能并非预防性输血的指征。