药物诱导的免疫溶血性贫血研究进展

Progress in immune hemolytic anemia caused by drugs

药物诱导的免疫溶血性贫血(DIIHA)是一种罕见的血细胞减少症,药物诱导产生的抗体或非免疫性蛋白吸附(NIPA)可造成红细胞(RBCs)的破坏。与DIIHA相关的药物和被认为涉及的机制假说在过去几十年中是有争议的,为了诊断,常常需要专门的血液免疫学实验室进行复杂的血清学试验。了解其临床表现和实验室辅助诊断技术是区分药物引起的免疫血液学异常或其他原因的必要条件,及时诊断和正确治疗是一个亟待解决的问题。本文对其进行了综述,以帮助临床提高对DIIHA的诊断能力,建立一条科学合理的DIIHA血清学检测思路。

Drug⁃induced immune hemolytic anemia(DIIHA)is a rare cytopenia caused by damage to RBCs by drug⁃in⁃duced antibodies or non⁃immune protein adsorption(NIPA).The drugs associated with DIIHA and the mechanistic hypothe⁃ses that are thought to be involved have been controversial,with complex serological tests often required by specialized Im⁃mune Hematology laboratories for diagnosis.It is necessary to know the clinical manifestation and laboratory diagnosis of DI⁃IHA in order to distinguish the immuno⁃hematological abnormality caused by drugs from other causes.How to improve the di⁃agnostic ability of DIIHA and establish a scientific and reasonable idea of DIIHA serological examination is urgent to help clinical diagnosis and correct treatment.