实体瘤伴冷凝集现象两例并文献复习

Solid Tumors With Cold Agglutinins:Report of Two Cases and Literature Review

冷凝集素是一种针对红细胞表面糖类抗原I或i的自身抗体,以IgMκ型为主,在体温降低时可引起红细胞凝集。它通常与感染、药物反应、自身免疫性疾病和血液系统恶性肿瘤有关,在实体瘤中的报道罕见。本文报告2例实体瘤患者外周血出现的冷凝集现象。患者入院时血常规检测均显示红细胞计数和红细胞压积明显降低,红细胞计数和血红蛋白浓度不匹配,平均血红蛋白含量和平均血红蛋白浓度异常升高,血涂片显微镜检查显示红细胞聚集。标本在37℃孵育后,观察到冷凝集的可逆性,红细胞及其参数得到纠正。

Cold agglutinins(CA),autoantibodies against the antigen I or i on the surface of red blood cells,are mainly of IgM class,and the majority haveκlight chains.They can lead to red blood cell agglutination at decreased body temperature and are usually associated with infections,drug reactions,autoimmune diseases,and hematological malignancies.However,solid tumors with CA are rare.We reported two cases of CA in the peripheral blood of patients with solid tumors.Peripheral complete blood cell count of the patients at admission showed reduced erythrocyte count and hematocrit,mismatching between erythrocyte count and hemoglobin,abnormally elevated levels of mean corpuscular hemoglobin and mean cell hemoglobin concentration.Peripheral blood smear showed erythrocyte aggregation.After the sample was preheated at 37℃for 30 min,the reversibility of red blood cell aggregation was observed,and the erythrocyte parameters were corrected.