肾移植术后并发难治性纯红细胞再生障碍性贫血1例并文献复习  

Pure red cell aplasia following renal transplantation:one case report and literature review

作　　者：蔡丽玲 胡颖 徐丽芬 吴耀辉[2] 

机构地区：[1]华中科技大学同济医学院附属协和医院泌尿外科,武汉430022 [2]华中科技大学同济医学院附属协和医院血液内科

出　　处：《临床血液学杂志》2018年第5期714-716,共3页Journal of Clinical Hematology

摘　　要：纯红细胞再生障碍性贫血（pure red cell aplasia,PRCA）是一种骨髓红系选择性增生障碍所致的一组少见的综合征,表现为进行性加重的正细胞贫血,伴网织红细胞（Ret）显著减少或缺如,骨髓中有核细胞并不减少,粒细胞和巨核细胞系列增生正常,但幼红细胞系列显著减少或缺如[1]。微小病毒B19是一种人类常见的无包膜单链DNA病毒,与多种疾病的发生有关。A 32-year-old male patient presented severe anemia after renal transplantation and the diagnosis of pure red cell aplasia（PRCA）was established through bone marrow and blood examination.With a literature review,the understanding of diagnosis and treatment of PRCA after renal transplantation was summarized.After diagnosis,the patient was treated with IVIG and PRCA relieved.Before the second relapse,B19 virus infection was confirmed by PCR analysis.After adjustment of immnosuppressors and administration of IVIG,the patient obtained a stable recovery in the level of hemoglobin.PRCA should be considered while patients after renal transplantation endure one decreased level in one lineage of red blood cell.The screening tests in blood and bone marrow should be done,especially B19 virus infection.Administration of IVIG and adjustment of immunosuppressors are major treatments of these patients.

关 键 词：肾移植 微小病毒B19 纯红细胞再生障碍性贫血 

分 类 号：R556.5[医药卫生—血液循环系统疾病]