以溶血性贫血为首发表现的系统性红斑狼疮

Systemic lupus erythematosus with hemolytic anemia as an initial symptom

报告1例以溶血性贫血为首发表现的系统性红斑狼疮(SLE)。患者女,18岁。在出现SLE典型临床表现之前2年出现溶血性贫血症状,经Coombs试验确诊为自身免疫性溶血性贫血。回顾相关文献发现,以溶血性贫血为首发症状的SLE少见,且多伴有抗心磷脂抗体阳性,后者是否是导致溶血的直接原因目前仍有争议。该例患者将来可能出现继发性抗磷脂综合征的症状,如血栓形成、血小板减少、自发性流产等,应密切随访。

An 18-year-old girl with systemic lupus erythematosus （SLE） is described. She first presented with typical symptoms of autoimmune hemolytic anemia （AIHA） and an elevated titer of anticardiolipin autoantibodies （ACLA）. Whether ACLA plays a key role in the pathogenesis of hemolysis remains to be elucidated, but an abnormal ACLA titer may imply the possibility of development of antiphospholipid syndrome, so the patient should be followed up.