Latent Autoimmune Hemolytic Syndrome

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  • Kuroyanagi Takeo
    The Third Department of Internal Medicine Faculty of Medicine, University of Tokyo
  • Sugiyama Hajime
    The Third Department of Internal Medicine Faculty of Medicine, University of Tokyo

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The direct anti-globulin test was performed at random on 310 hospitalized patients with various diseases. Thirty-three patients were positive to anti-globulin test without any evidence of manifest autoimmune hemolytic anemia.<br> Hematologic and erythrokinetic studies on these patients with latent autoimmune hemolytic syndrome revealed that their slight anemia was secondary anemia due to their basic diseases with a slightly increased hemolysis.<br> The basic diseases of these patients were autoimmune diseases, mesenchymal disease, chronic infections, hypersensitivity disease, pulmonary silicosis associated with tuberculosis, leukemia, Hodgkin's disease and others.<br> Anti-erythrocyte autoantibodies were of warm type and intermediate type except for one case of γ-globulin type. The immunoglobulin class of anti-erythrocyte autoantibodies was IgG. Their light chain type was as follows: K type, 2; λ type 5; and K+λ type, 1. The coexistence of other various autoantibodies was demonstrated in most of the patients.<br> A marked increase of peripheral large lymphocytes, hyperplasia of germinal centers associated with proliferations of reticulum cells and lymphogonias (immunoblasts) and a marked infiltration of plasma cells were demonstrated in biopsied lymph nodes.<br> The mechanism of the association of latent au toimmune hemolytic syndrome with basic diseases was discussed.

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