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Refractory autoimmune hemolytic anemia in a patient with systemic lupus erythematosus and ulcerative colitis:A case report
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作者 Dai-Xing Chen Yue Wu +1 位作者 Sui-Feng Zhang Xiao-Jun Yang 《World Journal of Clinical Cases》 SCIE 2024年第13期2286-2292,共7页
BACKGROUND Ulcerative colitis(UC)and systemic lupus erythematosus(SLE)are both systemic immunoreactive diseases,and their pathogenesis depends on the interaction between genes and environmental factors.There are no re... BACKGROUND Ulcerative colitis(UC)and systemic lupus erythematosus(SLE)are both systemic immunoreactive diseases,and their pathogenesis depends on the interaction between genes and environmental factors.There are no reports of UC with SLE in China,but six cases of SLE with UC have been reported in China.The combination of these two diseases has distinct effects on the pathogenesis of both diseases.CASE SUMMARY A female patient(30 years old)came to our hospital due to dull umbilical pain,diarrhea and mucous bloody stool in August 2018 and was diagnosed with UC.The symptoms were relieved after oral administration of mesalazine(1 g po tid)or folic acid(5 mg po qd),and the patient were fed a control diet.On June 24,2019,the patient was admitted for treatment due to anemia and tinnitus.During hospitalization,the patient had repeated low-grade fever and a progressively decreased Hb level.Blood tests revealed positive antinuclear antibody test,positive anti-dsDNA antibody,0.24 g/L C3(0.9-1.8 g/L),0.04 g/L C4(0.1-0.4 g/L),32.37 g/L immunoglobulin(8-17 g/L),and 31568.1 mg/24 h total 24-h urine protein(0-150 mg/24 h).The patient was diagnosed with SLE involving the joints,kidneys and blood system.Previously reported cases of SLE were retrieved from PubMed to characterize clinicopathological features and identify prognostic factors for SLE.CONCLUSION The patient was discharged in remission after a series of treatments,such as intravenous methylprednisolone sodium succinate,intravenous human immunoglobulin,cyclophosphamide injection,and plasma exchange.After discharge,the patient took oral prednisone acetate tablets,cyclosporine capsules,hydroxychloroquine sulfate tablets and other treatments for symptoms and was followed up regularly for 1 month,after which the patient's condition continued to improve and stabilize. 展开更多
关键词 Plasma exchange autoimmune hemolytic anemia Systemic lupus erythematosus Ulcerative colitis Case report
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First case of IgG4-related sclerosing cholangitis associated with autoimmune hemolytic anemia 被引量:4
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作者 Hironori Masutani Kosuke Okuwaki +6 位作者 Mitsuhiro Kida Hiroshi Yamauchi Hiroshi Imaizumi Shiro Miyazawa Tomohisa Iwai Miyoko Takezawa Wasaburo Koizumi 《World Journal of Gastroenterology》 SCIE CAS 2014年第26期8740-8744,共5页
To our knowledge,patients with immunoglobulin G4-related sclerosing cholangitis(IgG4-SC)associated with autoimmune hemolytic anemia(AIHA)have not been reported previously.Many patients with IgG4-SC have autoimmune pan... To our knowledge,patients with immunoglobulin G4-related sclerosing cholangitis(IgG4-SC)associated with autoimmune hemolytic anemia(AIHA)have not been reported previously.Many patients with IgG4-SC have autoimmune pancreatitis(AIP)and respond to steroid treatment.However,isolated cases of IgG4-SC are difficult to diagnose.We describe our experience with a patient who had IgG4-SC without AIP in whom the presence of AIHA led to diagnosis.The patient was a73-year-old man who was being treated for dementia.Liver dysfunction was diagnosed on blood tests at another hospital.Imaging studies suggested the presence of carcinoma of the hepatic hilus and primary sclerosing cholangitis,but a rapidly progressing anemia developed simultaneously.After the diagnosis of AIHA,steroid treatment was begun,and the biliary stricture improved.IgG4-SC without AIP was thus diagnosed. 展开更多
关键词 IgG4-related sclerosing cholangitis Immunoglobulin G4-related sclerosing cholangitis autoimmune hemolytic anemia autoimmune hemolytic anemia autoimmune pancreatitis
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Oxidative stress as a potential causal factor for autoimmune hemolytic anemia and systemiclupuserythematosus 被引量:8
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作者 Junichi Fujii Toshihiro Kurahashi +2 位作者 Tasuku Konno Takujiro Homma Yoshihito Iuchi 《World Journal of Nephrology》 2015年第2期213-222,共10页
The kidneys and the blood system mutually exert infuence in maintaining homeostasis in the body. Because the kidneys control erythropoiesis by producing erythropoietinand by supporting hematopoiesis, anemia is associa... The kidneys and the blood system mutually exert infuence in maintaining homeostasis in the body. Because the kidneys control erythropoiesis by producing erythropoietinand by supporting hematopoiesis, anemia is associated with kidney diseases. Anemia is the most prevalent genetic disorder, and it is caused by a deficiency of glucose 6-phosphate dehydrogenase (G6PD), for which sulfhydryl oxidation due to an insufficient supply of NADPH is a likely direct cause. Elevated reactive oxygen species (ROS) result in the sulfhydryl oxidation and hence are another potential cause for anemia. ROS are elevated in red blood cells (RBCs) under superoxide dismutase (SOD1) defciency in C57BL/6 mice. SOD1 defcient miceexhibit characteristics similar to autoimmune hemolytic anemia (AIHA) and systemic lupus erythematosus (SLE) at the gerontic stage. An examination of AIHA-prone New Zealand Black (NZB) mice, which have normal SOD1 and G6PD genes, indicated that ROS levels in RBCs are originally high and further elevated during aging. Transgenic overexpression of human SOD1 in erythroid cells effectively suppresses ROS elevation and ameliorates AIHA symptoms such as elevated anti-RBC antibodies and premature death in NZB mice. These results support the hypothesis that names oxidative stress as a risk factor for AIHA and other autoimmune diseases such as SLE. Herein we discuss the association between oxidative stress and SLE pathogenesis based mainly on the genetic and phenotypic characteristics of NZB and New Zealand white mice and provide insight into the mechanism of SLE pathogenesis. 展开更多
关键词 autoimmune hemolytic anemia Systemic lupus erythematosus Red blood cells New Zealand black mice New Zealand white mice
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Iguratimod in treatment of primary Sjögren’s syndrome concomitant with autoimmune hemolytic anemia:A case report 被引量:1
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作者 Juan Zhang Xin Wang +4 位作者 Jing-Jing Tian Rong Zhu Rui-Xue Duo Yi-Chen Huang Hai-Li Shen 《World Journal of Clinical Cases》 SCIE 2022年第4期1286-1290,共5页
BACKGROUND Primary Sjögren's syndrome(pSS)concomitant with autoimmune hemolytic anemia(AIHA)but without eye and mouth dryness is exceedingly rare.Iguratimod(IGU)has been widely used in the treatment of pSS.Ho... BACKGROUND Primary Sjögren's syndrome(pSS)concomitant with autoimmune hemolytic anemia(AIHA)but without eye and mouth dryness is exceedingly rare.Iguratimod(IGU)has been widely used in the treatment of pSS.However,there are few reports about the application of IGU in pSS concomitant with AIHA.CASE SUMMARY Here,we present the case of a patient with pSS concomitant with AIHA but without eye and mouth dryness.The patient was initially diagnosed with hyperplastic anemia and AIHA while pSS was missed,and was finally diagnosed with pSS concomitant with AIHA.The patient was treated with IGU along with prednisone and hydroxychloroquine,and her hemoglobin,reticulocytes and IgG returned to normal levels.CONCLUSION IGU was effective for and well tolerated by our patient with pSS concomitant with AIHA,and may be a promising therapy for the treatment of this disease. 展开更多
关键词 autoimmune hemolytic anemia IGURATIMOD Primary Sjögren’s syndrome Case report
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Giant cell hepatitis with autoimmune hemolytic anemia in a nine month old infant
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作者 Jihene Bouguila Sameh Mabrouk +4 位作者 Samia Tilouche Dajla Bakir Amel Trabelsi Amel Hmila Lamia Boughammoura 《World Journal of Hepatology》 CAS 2013年第4期226-229,共4页
Giant cell hepatitis(GCH)with autoimmune hemolytic anemia is a rare entity,limited to young children,with an unknown pathogenesis.We report the case of 9-mo old who presented with fever,diarrhea and jaundice four days... Giant cell hepatitis(GCH)with autoimmune hemolytic anemia is a rare entity,limited to young children,with an unknown pathogenesis.We report the case of 9-mo old who presented with fever,diarrhea and jaundice four days before hospitalization.Physical examination found pallor,jaundice and hepatosplenomegaly.The laboratory workup showed serum total bilirubin at 101 μmol/L,conjugated bilirubin at 84 μmol/L,hemolytic anemia,thrombocytopenia and immunoglobulin G(IgG)and anti-C3d positive direct Coombs' test.The antinuclear,anti-smooth muscle and liver kidney microsomes 1 non-organ specific autoantibodies,antiendomisium antibodies were negative.Serological assays for viral hepatitis B and C,cytomegalovirus,herpes simplex and Epstein Barr virus were negative.The association of acute liver failure,Evan's syndrome,positive direct Coomb's test of mixed type(IgG and C3)and the absence of organ and non-organ specific autoantibodies suggested the diagnosis of GCH.The diagnosis was confirmed by a needle liver biopsy.The patient was treated by corticosteroids,immunomodulatory therapy and azathioprine but died with septicemia. 展开更多
关键词 Giant cell HEPATITIS anemia hemolytic autoimmune Child
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Direct antiglobulin test-negative autoimmune hemolytic anemia in a patient withβ-thalassemia minor during pregnancy:A case report
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作者 Yang Zhou Yi-Ling Ding +2 位作者 Li-Juan Zhang Mei Peng Jian Huang 《World Journal of Clinical Cases》 SCIE 2022年第4期1388-1393,共6页
BACKGROUND Severe refractory anemia during pregnancy can cause serious maternal and fetal complications.If the cause cannot be identified in time and accurately,blind symptomatic support treatment may cause serious ec... BACKGROUND Severe refractory anemia during pregnancy can cause serious maternal and fetal complications.If the cause cannot be identified in time and accurately,blind symptomatic support treatment may cause serious economic burden.Thalassemia minor pregnancy is commonly considered uneventful,and the condition of anemia rarely progresses during pregnancy.Autoimmune hemolytic anemia(AIHA)is rare during pregnancy with no exact incidence available.CASE SUMMARY We report the case of a 30-year-oldβ-thalassemia minor multiparous patient experiencing severe refractory anemia throughout pregnancy.We monitored the patient closely,carried out a full differential diagnosis,made a diagnosis of direct antiglobulin test-negative AIHA,and treated her with prednisone and intravenous immunoglobulin.The patient gave birth to a healthy full-term baby.CONCLUSION Coombs-negative AIHA should be suspected in cases of severe hemolytic anemia in pregnant patients with and without other hematological diseases. 展开更多
关键词 Maternal anemia β-thalassemia minor autoimmune hemolytic anemia Direct antiglobulin test PREGNANCY Case report
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Infantile giant cell hepatitis with autoimmune hemolytic anemia
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作者 Dimitri Poddighe Aidana Madiyeva +1 位作者 Diana Talipova Balzhan Umirbekova 《World Journal of Hepatology》 2021年第4期411-420,共10页
Giant cell hepatitis(GCH)is characterized by large and multinucleated(syncytial)hepatocytes in the context of liver inflammation.Infantile GCH is typically associated with autoimmune hemolytic anemia in the absence of... Giant cell hepatitis(GCH)is characterized by large and multinucleated(syncytial)hepatocytes in the context of liver inflammation.Infantile GCH is typically associated with autoimmune hemolytic anemia in the absence of any other systemic or organ-specific autoimmune comorbidity.The etiology is unknown;concomitant viral infections(as potential trigger factors)have been identified in a few patients.The pathogenesis reportedly relies upon immune-mediated/autoimmune mechanisms.This condition should be considered in any infant developing Coombs-positive anemia;indeed,anemia usually precedes the development of hepatitis.The clinical course is usually aggressive without the appropriate immunosuppressive therapy,which may include steroids,conventional immunosuppressors(e.g.,azathioprine and cyclophosphamide as first-line treatments),intravenous immunoglobulin,and biologics(rituximab).Improvements in medical management(including the availability of rituximab)have significantly reduced the mortality of this condition in the last decade. 展开更多
关键词 Giant cell hepatitis autoimmune hemolytic anemia RITUXIMAB Infantile hepatitis JAUNDICE HYPERBILIRUBINEMIA
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Treament of autoimmune hemolytic anemia by blood transfusion (17 case report attached hereto)
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《中国输血杂志》 CAS CSCD 2001年第S1期395-,共1页
关键词 case report attached hereto Treament of autoimmune hemolytic anemia by blood transfusion
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自身免疫性溶血性贫血(AIHA)患者意外抗体类型与输血疗效相关性分析 被引量:1
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作者 黎淑贞 蓝文莉 +2 位作者 马伟文 谢敬文 温吉桃 《中国输血杂志》 CAS 2024年第5期598-601,共4页
目的分析广州地区AIHA患者抗体类型并跟踪输血疗效,为AIHA患者临床输血治疗策略提供参考依据。方法在2021年1月—2023年10月本地区医院输血科(血库)送检至本站的96份疑难交叉配血标本分析鉴定出25份AIHA患者标本,再对其进行血型鉴定、R... 目的分析广州地区AIHA患者抗体类型并跟踪输血疗效,为AIHA患者临床输血治疗策略提供参考依据。方法在2021年1月—2023年10月本地区医院输血科(血库)送检至本站的96份疑难交叉配血标本分析鉴定出25份AIHA患者标本,再对其进行血型鉴定、Rh系统的抗原表型分型、抗体筛查及交叉配血,分析AIHA患者抗体类型与输血疗效的相关性。结果25份AIHA患者标本中,ABO正反定型相符17份,8份正反定型不符。主侧配血不相合19(19/25,76%)份,其中直接Coombs试验阳性+自身抗体阳性+无特异性抗体阳性18(18/19,94.7%)份;自身抗体+同种抗体阳性1(1/19,5.3%)份。主侧配血相合6(6/25,24%)份,其中自身抗体阳性3(3/6,50%)份;自身抗体+同种抗体阳性3(3/6,50%)份。25名AIHA患者中20名患者有输血治疗并能追踪到输血疗效,5名患者没有输血治疗或转院而无法追踪。输血有效11(11/20,55%)例;输血部分有效6(6/20,30%)例;输血无效3(3/20,15%)例。配血不合病例中,输血有效或部分有效17(17/20,85%)例。结论AIHA患者的输血疗效与交叉配血结果并无直接联系,在调节干预自身免疫内环境并排除同种意外抗体导致的配血不相合前提下,配血不合的AIHA患者在充分权衡利弊的情况下,必要时可输血,选择ABO、Rh系统抗原同型血液,可提高输血安全性和有效率。 展开更多
关键词 自身免疫性溶血性贫血 意外抗体 交叉配血 输血疗效 广州地区
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Acute kidney injury following autoimmune hemolytic anemia due to simultaneous use of ciprofloxacin and hydrochlorothiazide:A case report and review of the literature
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作者 Fatemeh Yaghoubi Farnaz Tavakoli +1 位作者 Davood Dalil Hoda Jamaloo 《Rheumatology & Autoimmunity》 2023年第1期56-62,共7页
Introduction:Rare cases of autoimmune hemolytic anemia(AHA)associated with using ciprofloxacin or hydrochlorothiazide(HCTZ)alone have been reported before.However,simultaneous use of both drugs could lead to a severe ... Introduction:Rare cases of autoimmune hemolytic anemia(AHA)associated with using ciprofloxacin or hydrochlorothiazide(HCTZ)alone have been reported before.However,simultaneous use of both drugs could lead to a severe clinical condition.This study presents the combination of acute kidney injury(AKI)and AHA following the simultaneous use of ciprofloxacin and HCTZ for three days.Case Description:A 42-year-old Iranian woman presented to the emergency department with symptoms of fatigue,lethargy,nausea and vomiting,ataxia,oliguria,dark urine,and jaundice.The patient reported using HCTZ due to high blood pressure and ciprofloxacin for a urinary tract infection three days before presentation.Early laboratory findings revealed hemolytic anemia with a hemoglobin of 7 g/dl,the strongly positive direct and indirect Coombs test,high level of lactate dehydrogenase(820 IU/L),and hyperbilirubinemia(total:3 mg/dL and direct:1.2 mg/dL).Furthermore,hyperkalemia(5.2 mEq/L),hyperphosphatemia(6.2 mg/dL),high levels of BUN(100 mg/dL),and creatinine rise(6.8 mg/dL)were found.Urine analysis showed 2+blood,4-6 red blood cells,and cola-colored urine.Based on the findings,druginduced AHA,followed by AKI,was diagnosed.Following,the drugs were stopped and steroid therapy was initiated.The patient underwent four sessions of hemodialysis to improve the AKI.Conclusion:Healthcare providers should be aware of the life-threatening adverse effects of commonly used drugs such as ciprofloxacin or HCTZ.The timely diagnosis of the offending drugs leads to avoiding the persistence of the risk factor and the deterioration of the patient's clinical condition. 展开更多
关键词 acute kidney injury autoimmune hemolytic anemia CIPROFLOXACIN HYDROCHLOROTHIAZIDE
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Autoimmune Diseases and Acquired Von Willebrand Disease in Two Cases of Progeria
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作者 Monem Makki Alshok 《International Journal of Clinical Medicine》 2014年第20期1269-1276,共8页
Ammar A., a 23-year-old male patient, who lives in Babylon, Haswa District, and his mother describes symptoms of growth retardation, skin changes, hair changes early graying and alopecia. These manifestation started e... Ammar A., a 23-year-old male patient, who lives in Babylon, Haswa District, and his mother describes symptoms of growth retardation, skin changes, hair changes early graying and alopecia. These manifestation started early during his childhood period. There is canseguanity between the patient’s mother & father also one of the patient’s sister has similar illness and one male brother died few months following his birth. We admit the patient to hospital due acute pulmonary infection in Jan 2009, which is controlled after a course of antibiotic and after 5 months he develops generalised mucocuteneous bullous eruption which shows partial response to oral prednisolone 2 mg/Kg. The patient has normal IQ and he is in the secondary school and he has normal blood picture and the only abnormal biochemical abnormalities is mild hyperlipidemia Serum cholestrol of 5.8 mmol/L and Serum Triglyceride of 260 mg/dl. Ammar’s Sister Qawthar A., who has a similar phenotypic manifestations, presented skin vitiligo and hepatosplenomegaly associated with sever anemia and jaundice and her presentation suggestive of autoimmune haemolytic anemia improved following blood transfusion, corticosteroid and azothioprim. In February 2014 Ammer presented with multiple and diffuse cuteneous ecchymymosis with markedly prolonged PTT and slightly proloned bleeding time highly consistent with acquired Von Willebrand’s disease. In conclusion premature aging is a predisposing factor for disturbed immunity and development of autoimmune diseases. 展开更多
关键词 PROGERIA autoimmune Diseases PEMPHIGUS autoimmune hemolytic anemia ACQUIRED Von Willebrand Disease
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T细胞免疫与WAIHA发病的关联研究进展 被引量:1
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作者 彭薇 宋雅琴 +3 位作者 韦爱萍 周秀英 温谋(综述) 谢政军(审校) 《海南医学》 CAS 2023年第11期1651-1655,共5页
一直以来对于温抗体型自身免疫性溶血性贫血(WAIHA)发病主要环节的认识主要集中在打破自身免疫耐受的B淋巴细胞过度激活增殖,继而产生大量抗红细胞的自身抗体。近年来随着研究的深入,临床逐渐认识到在WAIHA的这一病理变化背后亦有T淋巴... 一直以来对于温抗体型自身免疫性溶血性贫血(WAIHA)发病主要环节的认识主要集中在打破自身免疫耐受的B淋巴细胞过度激活增殖,继而产生大量抗红细胞的自身抗体。近年来随着研究的深入,临床逐渐认识到在WAIHA的这一病理变化背后亦有T淋巴细胞参与其中,体现在T细胞通过共刺激信号、Ca^(2+)-NEAT、JAK-STAT、PI3K/AKT/mTOR等分子通路影响异常B淋巴细胞在抗原识别、免疫呈递、异常增殖、抗体分泌各个阶段,致使T细胞亚群在结构、数量及质量上发生失衡:Th2、Th17、Treg的过度扩增,进一步明确不同亚群T细胞在WAIHA发病中的功能状态及导致该变化的关键分子通路节点,对于复发难治型WAIHA的治疗可能带来新的治疗思路和方向。 展开更多
关键词 温抗体型自身免疫性溶血性贫血 自身免疫性疾病 T淋巴细胞 分子通路 免疫调控紊乱
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Clinical and serological characterization of autoimmune hemolytic anemia after allogeneic hematopoietic stem cell transplantation 被引量:4
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作者 Yang Zhen Wu Bangzhao Zhou Youning Wang Wenjuan Chen Suning Sun Aining Wu Depei Xu Yang 《Chinese Medical Journal》 SCIE CAS CSCD 2014年第7期1235-1238,共4页
Background Autoimmune hemolytic anemia (AIHA) is an uncommon complication of allogeneic hematopoietic stem cell transplantation (allo-HSCT) which has only been reported in a few cases.We here aimed to explore its ... Background Autoimmune hemolytic anemia (AIHA) is an uncommon complication of allogeneic hematopoietic stem cell transplantation (allo-HSCT) which has only been reported in a few cases.We here aimed to explore its mechanism.Methods We retrospectively analyzed 296 patients who underwent allo-HSCT in our center from July 2010 to July 2012.Clinical manifestations were carefully reviewed and the response to currently available treatment approaches were evaluated.The survival and risk factors of AIHA patients after allo-HSCT were further analyzed.Results Twelve patients were diagnosed with AIHA at a median time of 100 days (15-720 days) after allo-HSCT.The incidence of AIHA after allo-HSCT was 4.1%.IgG antibody were detected in ten patients and IgM antibody in two patients.The two cold antibody AIHA patients had a better response to steroid corticoid only treatment and the ten warm antibody AIHA patients responded to corticosteroid treatment and adjustment of immunosuppressant therapy.Rituximab was shown to be effective for AIHA patients who failed conventional therapy.Survival analysis showed that the combination of AIHA in allo-HSCT patients hinted at poor survival.Cytomegalovirus (CMV) infection,graft-versus-host disease (GVHD) and histocompatibility leukocyte antigen (HLA) mismatch seemed to increase the risk of developing AIHA.Conclusions Patients who develop AIHA after allo-HSCT have poor survival compared to non-AIHA patients.Possible risk factors of AIHA are CMV infection,GVHD,and HLA mismatch.Rituximab is likely to be the effective treatment choice for the refractory patients. 展开更多
关键词 autoimmune hemolytic anemia allogeneic hematopoietic stem cell transplantation graft-versus-host disease
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AIHA患者血清中类同种特异性自身抗体的检出率及其分布情况探讨 被引量:23
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作者 张秋会 孙文利 +3 位作者 胡兴斌 安群星 张婧 尹文 《中国输血杂志》 CAS 北大核心 2016年第12期1352-1355,共4页
目的探讨自身免疫性溶血性贫血(AIHA)患者血清中类同种特异性自身抗体的检出率及其分布情况,进行回顾性统计与分析。方法应用抗球蛋白和微柱凝胶技术,对2008年1月-2015年12月,在本院住院需要输血的196名AIHA患者,进行输血前相关... 目的探讨自身免疫性溶血性贫血(AIHA)患者血清中类同种特异性自身抗体的检出率及其分布情况,进行回顾性统计与分析。方法应用抗球蛋白和微柱凝胶技术,对2008年1月-2015年12月,在本院住院需要输血的196名AIHA患者,进行输血前相关血型血清学检测,并且利用谱细胞鉴定AIHA患者血清中和红细胞上的抗体,进一步选择合适的抗原细胞,通过吸收放散试验区分同种抗体与类同种特异性自身抗体,同时对检出抗体的患者红细胞进行相应抗原检测。结果196例AIHA患者中,共检出自身抗体伴同种抗体86例占43.9%(86/196),单独自身抗体65例占33.2%(65/196),类同种特异性自身抗体45例占23.0%(45/196)。其中,类同种特异性自身抗体中,Rh血型系统抗原占77.8%(35/45),Kidd血型系统抗原占11.1%(5/45),Rh血型系统抗原混合Kidd血型系统抗体占6.7%(3/45),Duffy血型系统抗原占4.4%(2/45),MNSs血型系统抗原占2.2%(1/45)。此外,不同性别患者类同种特异性自身抗体的检出率比较,差异有统计学意义(X^2=6.00,P〈0.05)。结论AIHA患者类同种特异性自身抗体相当常见,多见于抗Rh血型系统抗原,少数见于Kidd血型系统抗原和Duffy血型系统抗原。了解类同种特异性自身抗体的发生频率和分布规律,为其制订适宜的输血方案,可进一步提高临床输血治疗的安全性和准确性。 展开更多
关键词 自身免疫性溶血性贫(aiha) 类同种特异性自身抗体 类同种特异性自身抗体分布
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小剂量利妥昔单抗治疗难治及复发性温抗体型AIHA临床研究 被引量:7
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作者 王吉刚 周凡 +4 位作者 刘彦琴 白颖 刘景华 张海婷 李敏燕 《临床军医杂志》 CAS 2015年第12期1211-1214,共4页
目的探讨小剂量利妥昔单抗治疗难治及复发温抗体型自身免疫性溶血性贫血(AIHA)的有效性和安全性。方法研究纳入11例难治及复发温抗体型自身免疫性溶血性贫血患者,给予利妥昔单抗100 mg静脉滴注,每周1次,连用4周;通过动态观察血红蛋白、... 目的探讨小剂量利妥昔单抗治疗难治及复发温抗体型自身免疫性溶血性贫血(AIHA)的有效性和安全性。方法研究纳入11例难治及复发温抗体型自身免疫性溶血性贫血患者,给予利妥昔单抗100 mg静脉滴注,每周1次,连用4周;通过动态观察血红蛋白、网织红细胞、总胆红素、间接胆红素、乳酸脱氢酶及直接抗人球蛋白试验(DAT)变化评价疗效,采用流式细胞术检测治疗前后CD3^+、CDl9^+CD20^+淋巴细胞数,免疫比浊法定量检测治疗前后血清免疫球蛋白(IgG、IgM、IgA)水平。结果治疗后,11例患者中5例(45.45%)完全缓解,3例(27.27%)部分缓解,而3例(27.28%)无效,总有效率为72.72%。小剂量利妥昔单抗治疗前后血清免疫球蛋白及CD3^+淋巴细胞数无明显变化(P>0.05),但CDl9^+CD20^+淋巴细胞数较治疗前明显下降(P<0.01),并达到清除水平。2例患者输注小剂量利妥昔单抗过程中发生输液反应,1例随访期间发生细菌性肺炎,经抗感染后治愈。结论小剂量利妥昔单抗治疗难治及复发温抗体型自身免疫性溶血性贫血安全、有效的,但其最佳用药方案尚需更多临床患者观察加以验证。 展开更多
关键词 利妥昔单抗 治疗 自身免疫性溶血性贫血
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糖皮质激素与洗涤红细胞输注联合治疗AIHA的疗效观察 被引量:9
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作者 谢一唯 李育 陈秉宇 《浙江医学》 CAS 2016年第16期1348-1350,共3页
目的探究自身免疫性溶血性贫血(AIHA)患者的输血对策及其疗效和安全性。方法将206例AIHA患者根据治疗方案的不同分为A组和B组,各103例。A组患者予以糖皮质激素治疗,同时筛选ABO、Rh血型系统与患者相同的献血员进行交叉配血,采用反应强... 目的探究自身免疫性溶血性贫血(AIHA)患者的输血对策及其疗效和安全性。方法将206例AIHA患者根据治疗方案的不同分为A组和B组,各103例。A组患者予以糖皮质激素治疗,同时筛选ABO、Rh血型系统与患者相同的献血员进行交叉配血,采用反应强度最弱且凝集强度小于自身对照的红细胞悬液,制成洗涤红细胞进行输血治疗。B组患者仅予以糖皮质激素治疗。分析红细胞不相合输注治疗AIHA的疗效和安全性。结果 A组患者输血治疗后Hb水平明显高于输血治疗前(P<0.05)。A组与B组患者治疗前Hb水平比较无统计学差异(P>0.05);而治疗后,A组患者Hb水平高于B组患者(P<0.05)。A组患者均无溶血性输血反应发生。结论对于重度贫血的AIHA患者,采用糖皮质激素与最少不相合洗涤红细胞输注联合治疗能有效缓解贫血,是安全和有效的,值得在临床推广应用。 展开更多
关键词 自身免疫性溶血性贫血 输血治疗 自身抗体 安全性 有效性
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洗涤红细胞和去白悬浮红细胞输注治疗自身免疫性溶血性贫血的效果
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作者 朱翔 许珣 吴静 《中外医学研究》 2024年第2期62-65,共4页
目的:探讨洗涤红细胞和去白悬浮红细胞输注治疗自身免疫性溶血性贫血(AIHA)的效果。方法:回顾性选取2020年3月—2023年3月蚌埠医学院第一附属医院收治的64例AIHA患者作为研究对象。根据治疗方法的不同将其分为试验组和对照组,各32例。... 目的:探讨洗涤红细胞和去白悬浮红细胞输注治疗自身免疫性溶血性贫血(AIHA)的效果。方法:回顾性选取2020年3月—2023年3月蚌埠医学院第一附属医院收治的64例AIHA患者作为研究对象。根据治疗方法的不同将其分为试验组和对照组,各32例。对照组输注去白悬浮红细胞,试验组输注洗涤红细胞。比较两组输血后24 h临床疗效,输血前、输血后24 h相关指标,输血反应。结果:试验组总有效率高于对照组,差异有统计学意义(P<0.05)。输血后24 h,两组血红蛋白(Hb)、红细胞计数(RBC)升高,网织红细胞百分比(Ret)、总胆红素(TBIL)水平降低,试验组Hb、RBC高于对照组,差异有统计学意义(P<0.05)。两组输血反应发生率比较,差异无统计学意义(χ^(2)=1.016,P>0.05)。结论:对AIHA患者而言,在输血治疗中输注洗涤红细胞的总体有效率高于输注去白悬浮红细胞,并且Hb和RBC的提升效果更加明显。 展开更多
关键词 自身免疫性溶血性贫血 洗涤红细胞 输血
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AIHA患者应用两种配血方法的输血疗效比较 被引量:3
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作者 戴芳 党妮 李建武 《现代检验医学杂志》 CAS 2016年第2期130-132,共3页
目的通过比较自身免疫性溶血性贫血(AIHA)患者分别采用微柱凝集法和体外溶血试验两种配血方法进行输血的疗效,为AIHA患者寻找一种安全有效的配血方法。方法选取北京大学深圳医院2010年1月~2014年12月诊断为AIHA并且需要输血治疗的患... 目的通过比较自身免疫性溶血性贫血(AIHA)患者分别采用微柱凝集法和体外溶血试验两种配血方法进行输血的疗效,为AIHA患者寻找一种安全有效的配血方法。方法选取北京大学深圳医院2010年1月~2014年12月诊断为AIHA并且需要输血治疗的患者75侧,随机分为A组40例与B组35例,A组采用微柱凝集法配血共输血65人次,B组采用体外溶血试验配血共输血63人次,比较两组患者输血疗效。结果两组患者输血治疗后RBC计数与Hb水平均有上升,TBIL含量均下降。B组患者RBC计数,Hb水平升高幅度及TBIL含量下降幅度明显高于A组患者;两组Hb水平输血前比较差异无统计学意义(P〉0.05),输血后比较差异有统计学意义(P〈0.05),表明B组输血疗效优于A组。A组输注总有效率为67.69%,B组输注总有效率为93.65%,B组总有效率明显高于A组,两组比较差异有统计学意义(P〈0.05)。结论AIHA患者采用体外溶血试验配血方法可以筛选到更适合的供者红细胞,确保患者输血安全有效。 展开更多
关键词 自身免疫性溶血性贫血 微柱凝集法 体外溶血试验 输血
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AIHA/Evans综合征CD80、CD86和CD4+CD25+调节性T细胞的研究 被引量:2
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作者 黄继贤 许娜 +3 位作者 刘晓力 肖捷 张健 陈志勇 《临床和实验医学杂志》 2013年第8期561-563,共3页
目的探讨自身免疫性溶血性贫血(AIHA)/Evans综合征(AIHA同时或相继发生免疫性血小板减少性紫癜)患者外周血淋巴细胞共刺激分子CD80、CD86和CD4+CD25+调节性T细胞的表达水平,初步探讨共刺激分子CD80、CD86和CD4+CD25+调节性T细胞在AIHA/E... 目的探讨自身免疫性溶血性贫血(AIHA)/Evans综合征(AIHA同时或相继发生免疫性血小板减少性紫癜)患者外周血淋巴细胞共刺激分子CD80、CD86和CD4+CD25+调节性T细胞的表达水平,初步探讨共刺激分子CD80、CD86和CD4+CD25+调节性T细胞在AIHA/Evans综合征细胞免疫功能紊乱中的机制及其意义。方法应用流式细胞术检测24例次AIHA/Evans综合征患者治疗前后外周血淋巴细胞CD80、CD86和CD4+CD25+调节性T细胞比例的变化,并与正常对照组相比较。结果 AIHA/Evans综合征患者治疗前后与正常对照组比较CD80比例水平均无明显变化(P>0.05);发作时CD86表达水平高于对照组和治疗缓解组,差异具有统计学意义(P<0.05);CD4+CD25+调节性T细胞表达水平在AIHA/Evans综合征发作患者中表达明显下降,差异具有高度统计学意义(P<0.01)。结论淋巴细胞共刺激因子CD86和CD4+CD25+调节性T细胞异常表达可能参与AIHA/Evans综合征细胞免疫功能紊乱方面的发病机制。 展开更多
关键词 自身免疫性溶血性贫血Evans综合征CD80 CD86 CD4+CD25+调节性T细胞
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自身免疫性溶血性贫血患者临床护理研究进展
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作者 潘月 杨小莉 周婷婷 《实用临床医药杂志》 CAS 2024年第9期144-148,共5页
自身免疫性溶血性贫血(AIHA)是临床上较难治疗的贫血疾病。本文基于AIHA患者院内及院外护理展开综述研究,涵盖健康教育、心理护理、病情观察、延续护理等方面,以期为临床AIHA的治疗及护理提供参考。
关键词 自身免疫性溶血性贫血 临床护理 输血 血浆置换
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