CAJ | 학술논문

目的探讨使用抗人T-淋巴细胞兔免疫球蛋白（ATG）治疗后短期内并发自身免疫性溶血性贫血（AIHA）的临床特点，以提高对本病的认识。方法分析1例再生障碍性贫血患儿使用ATG后出现AIHA的临床诊治资料，并对相关文献进行复习。结果本例患儿于使用ATG后8d，出现贫血加重、尿色深、胆红素升高、乳酸脱氢酶上升、抗人球蛋白试验阳性，临床诊断为 ATG相关AIHA。应用足量甲泼尼龙治疗，输洗涤红细胞后得以有效控制。经文献查询，相关病例罕见。结论ATG治疗相关AIHA虽然临床罕见，但病情进展迅速，值得临床高度重视。
목적탐토사용항인T-림파세포토면역구단백（ATG）치료후단기내병발자신면역성용혈성빈혈（AIHA）적림상특점，이제고대본병적인식。방법분석1례재생장애성빈혈환인사용ATG후출현AIHA적림상진치자료，병대상관문헌진행복습。결과본례환인우사용ATG후8d，출현빈혈가중、뇨색심、담홍소승고、유산탈경매상승、항인구단백시험양성，림상진단위 ATG상관AIHA。응용족량갑발니룡치료，수세조홍세포후득이유효공제。경문헌사순，상관병례한견。결론ATG치료상관AIHA수연림상한견，단병정진전신속，치득림상고도중시。
Objective To well understand the clinical features of hemolytic anemia following intravenous antithymocyte globulin (ATG) treatment.Methods A retrospective study and review of literature retrieved from databases was conducted to study the clinical characteristics of a 9-year-old boy who was treated with ATG for aplastic anemia.Results The patient developed hemoglobin level down from 99g/L to 56g/L in peripheral blood at day 8 after ATG treatment,with darkened urine,elevated bilirubin and lactase dehydrogenase and positive Coombs test.Therefore ATG associated immune hemolytic anemia was diagnosed and high dose methylprednisone was used.Review of literature shows the condition is rare. Conclusions ATG associated immune hemolytic anemia is a rare complication which needs clinical attention.