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一、温抗体型自身免疫性溶血性贫血(AIHA) 临床表现:原发性AIHA者纳女性,年龄不限。临床表现除溶血贫血外,无典型症状。半数有脾肿,1/3有黄疸及肝大。继发性AIHA常伴有原发疾病的临床表现。 实验室险查:1.贫血程度不一,有时很严重,可暴发急性溶血危象。血片上可见多量球形细胞及数量不等幼红细胞与少量铁粒幼细胞。偶见红细胞被吞噬现象。网织红细胞增多。2.骨髓呈增生象以幼红细胞增生为主,偶见轻度巨幼红样变。3.再障危象时,网织红细胞极度减少,骨髓象呈再生障碍。4.广谱抗人球蛋白直接试验:阳性,主要为C_3,或IgG型。
First, the warm antibody type autoimmune hemolytic anemia (AIHA) Clinical manifestations: Primary AIHA who accept women, age limit. Clinical manifestations in addition to hemolytic anemia, no typical symptoms. Half have splenomegaly, 1/3 have jaundice and liver. Secondary AIHA is often accompanied by clinical manifestations of primary disease. Laboratory risk check: 1. Anemia of varying degrees, sometimes very serious, can be acute hemolysis crisis. Blood cells showed a large number of spherical cells and ranging from the number of young erythrocytes and a small amount of iron granulocytes. Occasionally erythrocyte phagocytosis phenomenon. Reticulocyte increase. 2. Bone marrow hyperplasia like erythroblast hyperplasia, occasionally mild megaloblastic changes. 3. aplastic crisis, reticulocyte extremely reduced bone marrow showed aplastic disorders. 4. Broad-spectrum anti-human globulin direct test: positive, mainly C_3, or IgG type.