以全血细胞减少为首发表现的脾边缘区淋巴瘤1例报告

脾边缘区淋巴瘤(splenic marginal zone lymphoma,SMZL)是指原发于脾脏的B淋巴细胞性非霍奇金淋巴瘤。SMZL的发病率低,国内以全血细胞减少为首发表现的SMZL报道较少。为提高临床医务人员对SMZL的认识,现将本院诊治的1例报道如下。1病例资料患者女性,76岁,以“腹胀、纳差1年,全血细胞减少3 d”为主诉于2016年6月23日于本院就诊。1年前曾于本院就诊,患者无明显诱因出现腹胀,伴有纳差,无腹痛、腹泻,无畏寒发热,无瘀斑瘀点,无咳嗽咳痰等不适,建议患者进一步检查明确原因,患者予以拒绝。     

Ticlopidine-induced aplastic anemia: two new case reports,review, and meta-analysis of 55 additional cases

Ticlopidine-induced aplastic anemia (TIAA) is considered very uncommon. We present two new cases, and we review 55 additional cases from the literature. The first case concerns a 70-year-old man who developed severe aplastic anemia 7 weeks after treatment with 500 mg of ticlopidine daily. The patient sustained a severe septic episode, was treated with antibiotics and GM-CSF, and recovered the 14(th) day after ticlopidine withdrawal. The second was an 82-year-old man receiving ticlopidine for 2 years when, during a febrile episode, he was found neutropenic with marrow aplasia. Ticlopidine withdrawal and treatment with antibiotics, transfusions, and G-CSF helped him to recover. When the data of the 57 patients are evaluated, a reversible direct cytotoxic effect of ticlopidine on the pluripotent/bipotent hematopoietic progenitor stem cell is proposed. It is estimated that the real incidence if TIAA is higher, and many cases, initially presented as agranulocytosis +/- thrombocytopenia, might be true aplastic anemias, not proven by marrow aspiration or trephine biopsy. There is no effective monitoring to prevent this side effect. Recombinant growth factors appear not to help in shortening the neutropenic period.     

Postoperative erythroderma with change of HLA phenotypes from heterozygotes to homozygotes: a report of two cases.

Fatal "postoperative erythroderma" (POE) developed in 2 patients treated with liver lobectomy and the transfusion of fresh blood. Their clinical features and skin-histological findings were indicative of acute graft-versus-host disease (GVHD). The HLA phenotypes of circulating lymphocytes of the 2 patients were heterozygous but became homozygous late in the clinical course and were identical with those of the blood donors. One of the patient's haplotypes was identical with the donor's homozygous haplotype. These findings suggest the mechanism of development of POE in apparently immunocompetent patients. The donor's T lymphocytes are histocompatible with the patient's tissues, are not rejected, and become engrafted. The patient's tissues are not histocompatible with the donor's, so that GVHD develops.     

Severe pancytopenia triggered by recombinant hepatitis B vaccine

We describe the case of a teenager who developed fever, arthritis, cutaneous vasculitis and severe pancytopenia 3 weeks after the third vaccination boost with a recombinant hepatitis B vaccine. Bone marrow examination showed paucity of late myeloid elements and, subsequently, maturation arrest. Interferon-gamma (IFN-gamma) production by peripheral blood mononuclear cells from the patient was dramatically increased. An underlying immune predisposition (HLA-DR3) may have indirectly enabled the vaccine to trigger a hepatitis B virus-specific cytotoxic T-lymphocyte response. It is therefore possible that the pancytopenia was induced by a dysregulation of the CD8+ T-cell compartment via increased IFN-gamma production.     

全血细胞减少为主要特征的儿童恶性肿瘤

全血细胞减少(pancytopenia,PCP)指外周血象中三种有形成分:红细胞系、白细胞系、血小板系同时减少(三系减少)的一种病理情况,PCP不是疾病的诊断,而是某些可引起血液有形成分减少性疾病的共同临床表现,可由造血系统疾病或非造血系统疾病引起。造血系统引起的全血细胞减少常见于再生障碍性贫血(AA)、低增生性白血病、     

以大细胞性贫血为突出表现的全血细胞减少症

全血细胞减少症(pancytopenia)是指外周血白细胞、红细胞和血小板同时减少的一种血液学现象,严重病例可相应出现发热、贫血、出血等临床表现,也可因血常规检查偶然发现。全血细胞减少症并非一种独立的疾病,发生机制主要包括生成减少和破坏增多。     

Copper deficiency mimicking myelodysplastic syndrome

Copper deficiency is a rare cause of pancytopenia that may be mistaken for myelodysplastic syndrome. Cytoplasmic vacuolization in erythroid and myeloid precursors is found on bone marrow examination. Patients with a history of abdominal surgery who present with anemia and neutropenia with dysplastic changes should have copper levels checked.     

Two Cases of Autoimmune Neutropenia Complicated with Other Lineages of Autoimmune Cytopenia,Successfully Treated with Prednisolone

Though adult-onset primary autoimmune pancytopenia (AIP) rarely follows a self-limited course, a standard treatment strategy has not yet been established. We herein report two cases, each involving primary autoimmune neutropenia complicated with autoimmune thrombocytopenia or Evans syndrome. They were refractory to granulocyte-colony stimulating factor, but all lineages of cytopenia promptly recovered with prednisolone (PSL). In case 1, PSL was tapered and discontinued six months after its initiation without AIP relapse. In case 2, PSL has been tapered for five months without relapse. To establish an optimal treatment strategy for AIP, it is necessary to accumulate more cases.     

全血细胞减少的巨幼细胞性贫血15例临床分析

目的 观察分析全血细胞减少的巨幼细胞性贫血的临床表现及其治疗前后的实验室变化。方法 用Ｓｙｓｍｅｘ Ｆ－８００血液分析仪检测外周血及其他实验室检测，并分别给叶酸、维生素Ｂ１２治疗。结果 １５种中均无出血倾向，其中黄疸４例，胸骨压痛３例。治疗前ＭＣＶ、ＭＣＨ、ＲＤＷ－ＣＶ、ＰＤＷ、ＭＰＶ均增高，治疗第４天，ＲＤＷ－ＣＶ明显增加（Ｐ〈０．０１）。结论 巨幼细胞性贫血为大细胞不均一性贫血，治疗早期其红细