著明な寒冷凝集を示したEvans型自己免疫性溶血性貧血の一例

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A 28-year-old woman with oppression on chest, nausea and hemoglobinuria was found to have severe anemia and agglutination of red blood cells, and was diagnosed as Evans type IgG auto-immune hemolytic anemia.<BR>Blood studies on admission: hemoglobin 3.1 g/dl, erythrocytes 590000/cmm, hematocrit 10 %, reticulocytes 366‰, thrombocytes 72500/cmm, indirect bilirubin 3.5 mg/dl, LDH 1170 unit and red blood cells survival time of<SUP>51</SUP>Cr was 4 days. Direct and indirect antiglobulin tests were positive, antibody was IgG of λA type, cold agglutinin titer 256 times and Donath-Landsteiner test negative. The agglutinin did not fix complement and was not eluted from red cell membrane in spite of high temperature.<BR>The findings in this case suggest that either IgM antibody, transformed IgG antibody or IgG isoagglutinin may contribute to the agglutination of red blood cells.
学校法人昭和大学・昭和医学会の論文