9例Coombs试验阴性自身免疫性溶血性贫血的治疗体会

Analysis on characterization of Coombs-negative autoimmune hemolytic anemia

目的:探讨Coombs试验阴性自身免疫性溶血性贫血的临床及实验室资料、治疗及预后,提高对该病的早期诊断.方法:回顾性分析9例Coombs试验阴性自身免疫性溶血性贫血的临床及实验室资料.结果:9例Coombs试验阴性自身免疫性溶血性贫血的实验室资料均符合血管外溶血.通过诊断性治疗8例患者达缓解和部分缓解而确诊;1例患者在随访过程中Coombs试验阴性转为阳性而确诊.结论:Coombs试验阴性自身免疫性溶血性贫血容易误诊,诊断性治疗有助于尽早诊断.

Objective: To improve the early diagnosis of Coombs-negative autoimmune hemolytic anemia by analyzing the clinical features, laboratory data, treatment and prognosis of this disease. Methods: Clinical and laboratory features of 9 patients with Coombs-negative autoimmune hemolytic anemia were reviewed. Results: Laboratory data of 9 patients with Coombs-negative autoimmune hemolytic anemia were consistent with extravascular hemolysis. Coombs-negative autoimmune hemolytic anemia of eight patients with remission and partial remission by diagnostic therapy were confirmed. During the follow-up, Negative Coombs test of one patient became positive and a definite diagnosis was made. Conclusion: Coombs-negative autoimmune hemolytic anemia is easy to be misdiagnosed, and diagnostic treatment is helpful for early diagnosis.