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[实体器官移植后溶血性贫血的鉴别诊断与治疗]

[The differential diagnosis and therapy of hemolytic anemias after the transplantation of solid organs].

作者信息

von Appen K

出版信息

Urol Nefrol (Mosk). 1998 Sep-Oct(5):41-3.

PMID:9820048
Abstract

The clinical sign "anemia" is found in a majority of patients after solid organ transplantation. A variety of etiological factors cause reduced red blood counts--in different situations hemolysis is the culprit. Thrombotic microangiopathy (hemolytic uremic syndrome, transplant rejection or induced by immunosuppressive therapy), infections (bacterial, viral, fungal), and autoalloimmune reactions (differences in blood-group or Rhesus-antigens, drug induced RBC lysis) are most important pathologies to be considered in differential diagnostic steps. Methods applied in diagnostics, underlying pathologies and therapeutic consequences are described based on the clinical history of three transplant patients from a single university department. Therefore, hemolysis as a possible and important situation following organ transplantation should be considered, immediately traced back to the underlying disorder and effectively treated.

摘要

“贫血”这一临床症状在大多数实体器官移植患者中都能发现。多种病因导致红细胞计数减少——在不同情况下,溶血是罪魁祸首。血栓性微血管病(溶血性尿毒症综合征、移植排斥或由免疫抑制治疗引起)、感染(细菌、病毒、真菌)以及自身同种免疫反应(血型或恒河猴抗原差异、药物诱导的红细胞溶解)是鉴别诊断过程中需要考虑的最重要病理情况。基于同一大学科室的三名移植患者的临床病史,描述了诊断中应用的方法、潜在病理情况及治疗后果。因此,应考虑溶血作为器官移植后一种可能且重要的情况,立即追溯其潜在病症并进行有效治疗。

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