慢性淋巴细胞白血病并发温冷双抗体型自身免疫性溶血性贫血和高冷球蛋白血症1例及文献复习  

Case report complicated the autoimmune hemolytic anemia with both warm and cold autoantibodies and cryoglobulinemia in chronic lymphocytic leukemia and literature review

作　　者：王学文[1] 李锋[1] 刘海宁[1] 翟勇平[1] 曹红琴[1] 

机构地区：[1]南京军区南京总医院血液病科,江苏南京210002

出　　处：《现代肿瘤医学》2008年第11期1977-1980,共4页Journal of Modern Oncology

摘　　要：1例进展期慢性淋巴细胞白血病(CLL)患者临床表现周身淋巴结肿大,反复感染(肺炎和败血症),典型的冷敏感征象表现肢端发绀、指(趾)坏疽溃疡,重度贫血,自身免疫性溶贫(AIHA),低温下严重的红细胞凝集和自血凝集试验强阳性,直接和间接Coomb's试验阳性,重度低补体血症,血中检出IgMλ型单株免疫球蛋白和显著增高的冷球蛋白血症及终末期血小板严重减低。此为个案罕见的病例。治疗上宜采取并用多种免疫抑制剂,如皮质激素联合环磷酰胺、瘤可然、硫唑嘌呤、环孢菌素、青霉胺(750mg/d)及α-干扰素等。抗CD20单抗利妥昔(Rituximab),对冷抗体综合征(CAS)的总反应率为45%-54%,疗效优于烷化剂、皮质激素和嘌呤类似物。Clinical manifests and experimental characteristics in this patient with advanced chronic lymphocytic leukemia,which included lymphoadenopathy in whole body,repeated severe infection(pneumonia and sepsis),typical cold sensitivity phenomena which showed digital cyanosis and gangrene of the finger-tips,severe anemia,autoimmune hemolytic anemia,severe erythrocytes agglutination under low temperature and strong positive autohemo-agglutination test,positive directed and indirected Coomb s test,severe blood hypo...

关 键 词：慢性淋巴细胞白血病 温冷双抗体型 自身免疫性 溶血性贫血 冷球蛋白血症 

分 类 号：R733.72[医药卫生—肿瘤]