Immune reconstitution to parvovirus B19 and resolution of anemia in a patient treated with highly active antiretroviral therapy

Immune reconstitution inflammatory syndrome (IRIS) is an unsolved problem in the treatment of human immunodeficiency virus (HIV)-1 infection. Despite the high seroprevalence of parvovirus B19 (PVB19) among HIV-1-positive patients, reports on PVB19-induced anemia, especially that associated with PVB19-related IRIS, in these patients are limited. We present the case of a man with acquired immunodeficiency syndrome who developed severe transfusion-dependent anemia and was seropositive and borderline positive for immunoglobulin-M and IgG antibodies against PVB19, respectively. PVB19-DNA was also detected in his serum. The patient was diagnosed with pure red cell anemia (PRCA) caused by a primary PVB19 infection and was treated with periodical blood transfusions. However, he subsequently tested negative for IgG antibodies and developed chronic severe anemia with high levels of PVB19 viremia. This indicated a transition from primary to persistent infection. After initiation of highly active antiretroviral therapy, the patient showed an inflammatory reaction with rapid deterioration of anemia and seroconversion of the IgG antibody to PVB19. Subsequently, PRCA was completely resolved, but the patient’s serum still contained low levels of PVB19-DNA. Thus, this was a case of IRIS associated with PVB19 infection. Our report highlights the significance of seroconversion to PVB19 in the diagnosis of IRIS and re-emphasizes the finding that persistently high levels of PVB19 viremia after primary infection are probably because of the lack of protective antibodies.     

Exacerbation of autoimmune hemolytic anemia associated with pure red cell aplasia after COVID-19: A case report

Autoimmune hemolytic anemia (AIHA) and pure red cell aplasia (PRCA) are rare complications of coronavirus disease 2019 (COVID-19). Herein, we report the case of a 28-year-old Japanese man who showed severe AIHA exacerbation associated with PRCA after COVID-19. AIHA was diagnosed and maintained for 5 years. Approximately 4 weeks after COVID-19, the patient developed severe anemia (hemoglobin level, 3.4 g/dL). Laboratory test results confirmed hemolytic exacerbation of IgG-mediated warm-type AIHA. Despite the hemolysis phase, the bone marrow revealed extreme hypoplasia of erythroblasts with a decreased reticulocyte count, similar to that observed in patients with PRCA. During oral prednisolone treatment, the patient recovered from anemia and showed increased reticulocyte count and reduced hypoplasia of marrow erythroblasts. Exacerbation of AIHA and PRCA was triggered by COVID-19 because other causes were ruled out. Although this case report highlights that COVID-19 could lead to hematological complications such as AIHA and PRCA, the exact mechanisms remain unclear.     

Pure red cell aplasia accompanied by COVID-19 successfully treated using cyclosporine

A 67-year-old Japanese man was admitted to our hospital with severe coronavirus disease 2019 (COVID-19) in March 2020. Mechanical ventilation was initiated 8 days after admission, due to severe respiratory failure. Multiple severe complications such as liver dysfunction, arrhythmia, brain infarction, and venous thromboembolism were also observed. We initially diagnosed Coombs test-positive warm autoimmune hemolytic anemia. Corticosteroids proved ineffective and anemia worsened with severe erythroid hypoplasia (0.5% erythroblasts in bone marrow), so we diagnosed pure red cell aplasia (PRCA). We also identified massive infiltration of cytotoxic T-lymphocytes expressing CD8, granzyme B, and perforin in bone marrow. Systemic cyclosporine was started, with full resolution of anemia and no need for blood transfusions after 4 weeks. We believe that this represents the first report of COVID-19-associated PRCA successfully treated using cyclosporine.     

Hypersensitivity syndrome and pure red cell aplasia following allopurinol therapy in a patient with chronic kidney disease

OBJECTIVE: To report a rare case of combined hypersensitivity syndrome and pure red cell aplasia (PRCA) following allopurinol therapy. CASE SUMMARY: A 43-year-old woman with underlying mesangioproliferative glomerulonephritis developed fever, generalized morbilliform rash, leukocytosis with marked eosinophilia, and hepatic dysfunction 3 weeks after starting allopurinol therapy (300 mg/day for 3 days followed by 200 mg/day) for hyperuricemia and arthritis. The clinical findings were judged to be a probable drug reaction according to the Naranjo probability scale. The drug-induced hypersensitivity syndrome (DHS) resolved after withdrawal of allopurinol and initiation of systemic corticosteroid therapy. However, there was progressive worsening of anemia with reticulocytopenia; PRCA was suspected. PRCA was judged to be a possible drug reaction according to the Naranjo probability scale. The patient refused blood transfusion and bone marrow biopsy. Recombinant human erythropoietin was initiated in addition to prednisolone 15 mg daily. Eleven days later (approximately 7 wk after allopurinol withdrawal), both the hemoglobin level and reticulocyte count began to rise. The patient consented to a bone marrow study at that time, which confirmed the presence of dysplasia involving only the erythroid lineage. DISCUSSION: Allopurinol may induce DHS, aplastic anemia, and, in rare instances, PRCA. We report the first case of PRCA concurrent with allopurinol-induced DHS in a patient with chronic kidney disease. Discontinuation of allopurinol is the first step in the treatment of such cases. The slow recovery of PRCA might be partly attributed to her underlying chronic kidney disease. CONCLUSIONS: To minimize serious DHS, proper indications for treatment and dosage adjustment should be closely observed when starting allopurinol therapy in patients with chronic kidney disease.     

High-dose methylprednisolone therapy in pure red cell aplasia

OBJECTIVE: To report our experience using high-dose methylprednisolone (HDMP) treatment in a patient with primary acquired pure red cell aplasia (PRCA) who failed to respond to conventional prednisone therapy. CASE SUMMARY: A 29-year-old woman reported weakness, was easily fatigued, and had developed palpitations. On physical examination, pallor and splenomegaly were detected. On blood smear, mild macrocytic anemia was seen. Bone marrow aspiration and biopsy revealed normocellularity, erythroid hypoplasia (E/M: 1/10), reduction in erythroid precursors, and normal megakaryocytes and myeloid series. No disease associated with secondary PRCA was detected. Oral prednisone 1 mg/kg (total 60 mg/d) was started as conventional treatment. However, the patient's status deteriorated and the hemoglobin concentration fell from 6.5 to 5.5 g/dL within the first week of hospitalization. HDMP was then begun. Treatment protocol consisted of methylprednisolone 30 mg/kg for 4 days, 20 mg/kg for 3 days, 10 mg/kg for 3 days, 5 mg/kg for 4 days, and 1 mg/kg for 2 weeks. The patient's hemoglobin concentration increased from 5.5 to 14.2 g/dL over a period of 9 weeks. Transient hyperglycemia and cushingoid appearance were seen during prednisone treatment. DISCUSSION: Exactly how steroids enhance erythropoiesis in PRCA is unknown. It seems likely that steroids render abnormal erythroid progenitors more sensitive to marrow growth factors, thereby permitting them to differentiate to functional precursors. HDMP treatment had been rarely used in patients with primary acquired PRCA. Limited studies using HDMP have shown variable results. CONCLUSIONS: HDMP treatment may be considered safe and effective in patients with primary acquired PRCA who do not respond to conventional steroid therapy.     

Erythrocyte and reticulocyte parameters in iron deficiency and thalassemia

Introduction: Red blood cells (RBCs) extended parameters or erythrocyte subsets are now reported by the new Sysmex XE 5000 analyzer. This study was aimed at establishing a characteristic analytical feature, including the new erythrocyte and reticulocyte parameters, in case of thalassemia trait and iron deficiency (IDA). Methods: Ninety healthy individuals, 136 β‐thalassemia carriers, 121 mild IDA, and 126 severe IDA patients were analyzed. Results: The values obtained for the RBC extended parameters were significantly different (P<0.0001) in the groups; the only exception was %Hypo‐He in the case of mild IDA and thalassemia (P=0.6226). %Hypo‐He was considerably greater in severe IDA (23.4%) than in mild cases (12.4%), P<0.0001. %MicroR was more increased in thalassemia (38.6 %) than in the mild IDA (16.5%, P<0.001) and in severe IDA (21.6%, P<0.001). Immature reticulocyte fraction (IRF) mean values in the groups were statistically different; the thalassemia group had an intermediate value (8.7%) between healthy (4.4%) and IDA (16.7 and 12.9%). Conclusions: Erythrocytosis and severe microcytosis, together with a high percentage of microcytes and a moderate increase in IRF, is the profile of β‐thalassemia carriers, whereas anisocytosis and the hypochromic subset correlates with the severity of the anemia in iron‐deficient patients. J. Clin. Lab. Anal. 25:223–228, 2011. © 2011 Wiley‐Liss, Inc.     

网织红细胞参数与红细胞参数在孕妇缺铁性贫血的临床应用研究

目的探讨网织红细胞参数与红细胞参数在孕妇缺铁性贫血(IDA)中的诊断价值。方法选取2011年1月至2013年1月收治的孕妇IDA患者220例为观察组,同时选取同期正常妊娠者200例为对照A组,并选取150例非妊娠妇女为对照B组,三组受试者分别采用测定外周血红细胞参数及网织红细胞等相关指标,对比分析三组患者检测结果的差异。结果妊娠期IDA组与对照组相比,红细胞各项参数差异具有统计学意义(P<0.05),对照A组与对照B组相比,血红蛋白(HGB)、红细胞压积(HCT)、红细胞计数(RBC)差异具有统计学意义(P<0.05),红细胞分布宽度(RDW)差异无统计学意义(P>0.05)。妊娠期IDA组两对照组相比,网织细胞各项参数差异具有显著性(P<0.05),对照A组与对照B组相比差异无统计学意义(P>0.05)。分别以红细胞参数[HGB、HCT、RBC、红细胞分布宽度(RDW)]以及网织细胞参数[网织红细胞血红蛋白量(CHr)、红细胞内血红蛋白量(CH)、平均红细胞体积(MCV)、平均网织红细胞体积(MCVr)、网织红细胞内血红蛋白量浓度(RDWr)]各指标的正常值与非正常值的临界值作为分界点对IDA进行检测,其中CHr及Hb的灵敏度及特异性较高,分别为93.8%、100%和92.6%、95.6%。结论应用网织红细胞参数以及红细胞参数联合诊断孕期IDA的灵敏度及特异度较高,具有重要的临床诊断价值。     

MCV/RDW结合网织红细胞参数在诊断贫血中的价值探讨

目的　观察各种疾病中度贫血患者平均红细胞体积 (MCV)、红细胞体积分布宽度(RDW )和网织红细胞 (RET)参数的指标变化。方法　采用Advia 12 0血细胞分析仪检测 2 0 0例各种疾病中度贫血患者MCV、RDW和RET参数 ,将所得数据进行统计学处理。结果　与正常对照组比较 ,急性白血病、大出血和血栓性血小板减少性紫癜贫血组MCV和RDW明显升高 ;在缺铁性贫血组RDW升高 ,但MCV降低 ;RET %除急性白血病和再障贫血组外 ,其余均偏高 ,中荧光强度网织红细胞 (MFR % )和高荧光强度网织红细胞 (HFR % )在各组贫血患者均显著升高。结论　MCV/RDW贫血分类法结合网织红细胞参数指标 ,不仅有助于贫血的病因分析 ,而且也是观察贫血疗效的一个可靠指标     

Using Reticulocyte Hemoglobin Equivalent as a Marker for Iron Deficiency and Responsiveness to Iron Therapy

ObjectiveTo assess the accuracy of a simplified approach for the diagnosis of iron deficiency anemia (IDA) based on the complete blood cell count (CBC) and reticulocyte analysis.Patients and MethodsFive hundred fifty-six consecutive, nonselected patients referred for diagnosis and/or treatment of anemia were included in this diagnostic study to compare the performance of reticulocyte hemoglobin equivalent (RET-He) versus traditional biochemical markers for diagnosis and treatment of IDA. Complete blood count, serum ferritin, iron, and transferrin saturation were performed as clinically indicated. Reticulocyte hemoglobin equivalent was measured with a Sysmex XN-450 analyzer on the residual CBC sample. The study period was from September 20, 2017, through and including November 15, 2018.ResultsPatients (N=556) were studied at baseline, of whom 150 were subsequently treated with intravenous iron. Receiver operating characteristic analysis yielded an RET-He cut-off of 30.7 pg to identify IDA (area under curve, 0.733; 95% CI, 0.692 to 0.775), with 68.2% sensitivity and 69.7% specificity. Patients (n=240) were seen at follow-up, with 57 treated and 183 not treated with intravenous iron. Responsiveness was defined as a hemoglobin increase of ≥1.0 g: a combination of RET-He <28.5 pg and hemoglobin value <10.3 g/dL had 84% sensitivity and 78% specificity as response predictor (area under the curve, 0.749; 95% CI, 0.622 to 0.875).ConclusionData from CBC and RET-He can identify patients with IDA, determine need for and responsiveness to intravenous iron, and reduce time for therapeutic decisions. Limitations of this study are uncontrolled design, its single-site and retrospective nature, and that it requires prospective validation.     

幽门螺杆菌感染与老年缺铁性贫血的相关性研究

目的 探讨幽门螺杆菌（Hp）感染与老年缺铁性贫血（IDA）的关系及Hp＋ IDA治疗的最佳方法.方法 入选107例确诊的老年IDA患者进行Hp检测（13C-呼气试验及Hp抗体IgG检测）,将其分为Hp＋及Hp-组,Hp＋组IDA患者又随机分为A、B、C三组,A组给予琥珀酸亚铁＋抗Hp治疗,B组给予蔗糖铁＋抗Hp治疗,C组仅给予琥珀酸亚铁治疗,Hp-组给予琥珀酸亚铁治疗.监测治疗前、治疗后2周时的血常规、网织红细胞;治疗前、治疗后8周时的血常规、血清铁、总铁结合力、血清铁蛋白.结果 治疗2周时B组及Hp-组网织红细胞显著高于治疗前（P＜0.05）,A组、C组较治疗前无明显变化（P＞0.05）;治疗8周时4组血红蛋白、血清铁、血清铁蛋白均高于治疗前（P＜0.01）,总铁结合力较治疗前下降（P＜0.01）,A组、B组及Hp-组的血清铁等指标高于C组（P＜0.05）.结论 Hp感染可造成或加重机体铁吸收不良,是老年IDA的病因之一,抗Hp治疗有助于提高Hp＋ IDA患者的临床疗效,是其治疗不可缺少的措施.对于老年IDA患者蔗糖铁注射液补铁治疗是一个较好的选择.     

网织红细胞参数在缺铁性贫血诊断中的价值

目的 探讨新型网织红细胞参数在缺铁性贫血（IDA）诊断中的临床诊断价值。方法 用Bayer ADVIA 120全自动血液分析仪对236例健康人群、101例非IDA患者和78例IDA患者的外周血红细胞和网织红细胞诸参数进行了检测，并对检验结果进行了对比分析。结果IDA患者的血红蛋白（Hb）、平均红细胞体积（MCV）、红细胞内血红蛋白量（CH）、平均网织红细胞体积（MCVr）、网织红细胞内血红蛋白量（CHr）及网织红细胞内血红蛋白量浓度（CHCMr）检测结果明显低于健康人群和非IDA患者（P〈0．01）；而网织红细胞体积分布宽度（RDWr）和网织红细胞细胞内血红蛋白量分布宽度（HDWr）的检测结果明显高于健康人群和非IDA患者（P〈0．01）。如果分别以RDWr〉11．0％、HDWr〉31．6g／L、CHr〈28．0pg／L、CHCMr〈285．0g／L及CH〈27．0pg／L为临界值诊断IDA，其灵敏度和特异性分别为：92．3％、75．6％、100％、100％、92．3％和74．2％、82．2％、89．6％、85．5％和90．2％。结论以CHr〈28．0pg／L及CH〈27．0pg／L为临界值联合诊断IDA效率最优，其假阳性率、假阴性率分别为9．2％和0％。次之为CHr〈28．0pg／L，诊断IDA的假阳性率、假阴性率分别为10．4％和0％。     

Pure red cell aplasia and myelofibrosis in B-cell neoplasm

We describe an unusual case of B-cell neoplasm accompanied by pure red cell aplasia (PRCA) and myelofibrosis in a 67-year-old male presenting with severe anaemia. A few unclassified, myeloperoxidase-negative blastoid cells were seen on bone marrow aspiration, and erythroid cell hypoplasia and myelofibrosis on bone marrow biopsy. An autoimmune PRCA was suspected, as serum CH50, C3 and C4 levels were consistently low. Ciclosporin was effective in treating the anaemia, but anaemia returned when the drug was discontinued. Thirteen months later, the patient was admitted with pleural effusion and ascites that contained monoclonal CD19+ CD20+ immature blast cells with a complex karyotype, thought to be neoplastic B-cells. The unclassified blastoid cells seen earlier may therefore have been from the same origin. The patient deteriorated rapidly and died. Only one case of non-Hodgkin's lymphoma with PRCA and myelofibrosis has been reported previously. We discuss the possibility that dysregulated T-cells induced by neoplastic B-cells may have given rise to concomitant PRCA and myelofibrosis.     

新型网织红细胞参数在缺铁性贫血疗效观察中的应用

目的　观察网织红细胞绝对数 (RET #)、网织红细胞内血红蛋白量 (CHr)、平均网织红细胞体积 (MCVr)及网织红细胞内血红蛋白浓度 (CHCMr)等网红参数在缺铁性贫血 (IDA)患者铁剂治疗中的动态变化 ,确定骨髓对铁剂治疗反应的早期指标。方法　用Advia 12 0血细胞分析仪对 13例缺铁性贫血患者在治疗过程中网红参数的变化进行了动态观察。结果　缺铁性贫血患者在铁剂治疗后 ,网红参数RET #、CHr、MCVr于第 4天明显升高 (P <0 0 1) ,第七天恢复正常 ;血红蛋白于第 14天明显升高 (P <0 0 1) ,第 2 8天恢复正常 ;CH、MCV、CHCM于第 2 8天明显升高 (P <0 0 1) ,第 4 9天后恢复正常 ;RDW于第 7天明显升高 (P <0 0 1) ,14天后又逐渐降低 ,第 12 0天恢复正常。结论　网红参数RET #、CHr、MCVr可作为评价缺铁性贫血患者铁剂治疗后骨髓对治疗反应最敏感的指标     

Hemolytic Disease of the Fetus and Newborn With Late-Onset Anemia due to Anti-M: A Case Report and Review of the Japanese Literature

Hemolytic disease of the fetus and newborn (HDFN) attributed to M/N-incompatibility varies from asymptomatic to lethally hydropic. Case reports are rare, and the clinical significance of anti-M is not completely understood. A challenging case of HDFN due to anti-M prompted an investigation of the Japanese literature, in order to characterize the clinical spectrum of M/N-incompatibility pregnancies in Japan and report results to English-language readers. Japanese reports of HDFN attributed to M/N incompatibility were compiled. Abstracted data include maternal antibody titers at delivery, fetal direct antiglobulin test, hemoglobin, total bilirubin, reticulocyte count at birth, and therapeutic interventions. We investigated characteristics of HDFN due to M/N-incompatible pregnancies in Japan after encountering a case of severe HDFN along with late-onset anemia in an infant born to a woman carrying IgG anti-M with a titer of 1. In total, thirty-three babies with HDFN due to anti-M and one due to anti-N have been reported in Japan since 1975. The median maternal antibody titer was 64 at delivery and was 16 or less in 10 of 34 women (29%). Five of 34 babies (15%) were stillborn or died as neonates. Twenty-one of 29 survivors (72%) had severe hemolytic anemia and/or hydrops fetalis. The reticulocyte count of neonates with anemia stayed below the reference interval. Sixteen (55%) developed late-onset anemia and 14 (48%) were transfused with M-negative RBCs. Significant positive correlation (P < .05) between the hemoglobin value and the reticulocyte count within 4 days of birth was obtained in 16 babies with anti-M HDFN. In the Japanese population, 21 of 34 cases of M/N-incompatible HDFN (72%) have manifested as severe hemolytic anemia and/or hydrops fetalis. Low reticulocyte count in neonates with late-onset anemia is consistent with suppressed erythropoiesis due to anti-M.     

Measurement of reticulocyte and red blood cell indices in patients with iron deficiency anemia and beta-thalassemia minor.

New parameters correlated with the hemoglobin content in reticulocytes (RET-Y) and in red blood cells (RBC-Y) have been suggested as helpful in diagnosing iron deficiency anemia. We have studied RET-Y and RBC-Y indices in two groups of patients with microcytosis to verify if these parameters could be used to differentiate iron deficiency anemia from beta-thalassemia minor. Blood samples from 33 iron-deficient patients, 25 beta-thalassemic minor patients and 50 normal individuals were analyzed on a Sysmex XE-2100 instrument. A significant difference was observed in reticulocyte counting and immature reticulocyte fraction between iron deficiency anemia and beta-thalassemia minor groups, but not in RBC-X and RET-Y parameters. Reticulocyte counting was higher in beta-thalassemia minor and the immature reticulocyte fraction was higher in severe iron deficiency anemia. The ratio RET-Y/mean cell volume was tested and was significantly different when beta-thalassemia minor was compared with mild and severe iron deficiency anemia, and showed better performance than the Mentzer ratio and the Green and King function. A great overlap of RET-Y and RBC-Y individual values was observed in both groups of microcytic anemias; we conclude that these new indices may be used with caution as indicative of iron deficiency, mainly in populations where beta-thalassemia minor is frequent.     

重组人促红细胞生成素致纯红细胞再生障碍性贫血5例临床观察

目的观察重组人促红细胞生成素致纯红细胞再生障碍性贫血(PRCA)患者经激素/环孢素干预的临床疗效。方法回顾性分析2008年4月至2011年4月在吉林大学第二医院血液净化中心透析且明确诊断为PRCA的5例患者,给予激素/环孢素干预,并观察用药前后贫血纠正情况、用药情况及临床疗效。结果 5例患者中2例单独使用足量激素干预有效,2例无效患者将激素减至中等剂量并加用环孢素后贫血改善。此4例患者血红蛋白维持在70-90g/L不再继续上升,重新应用促红细胞生成素后血红蛋白恢复到正常水平。该4例患者在停用激素/环孢素后随访8个月以上未复发。另一例(病例5)患者口服激素45mg/日,应用3个月后无效,换用环孢素,贫血得到初步改善,未应用促红细胞生成素,血红蛋白维持在70-80g/L。结论足量激素对部分患者有效,部分无效患者加用环孢素能够有效改善贫血,在病情得到稳定控制后,可加用促红细胞生成素进一步纠正贫血。     

系统性红斑狼疮并发贫血的类型分析

目的 分析系统性红斑狼疮（SLE）并发贫血的类型,并探讨其易于发生的危险因素.方法 根据贫血相关实验室指标和骨髓检查结果对239例SLE患者中并发贫血患者的贫血类型进行分析,并与无贫血的SLE患者的临床和实验室资料进行对比分析.结果 239例SLE患者中有127例（53.1%）发生贫血,对127例中89例资料完整患者的贫血类型分析结果显示,慢性疾病性贫血（ACD）有35例（39.3%）,缺铁性贫血（IDA）有32例（36.0%）,自身免疫性溶血性贫血（AIHA）有21例（23.6%）,其他类型贫血9例（10.1%）.同时有上述2种或2种以上类型贫血者7例（7.9%）.贫血程度以AIHA最为严重,其次为IDA,ACD则多为轻度贫血.AIHA和ACD以正细胞正色素性贫血为主,分别占90.5%和85.7%,而IDA则以小细胞低色素贫血为主,占87.5%.与34例无贫血的SLE患者对照,并发AIHA的患者关节炎、浆膜炎的发生率更高（P均〈0.05）,肾脏损害程度更重（P〈0.05）,补体C3水平明显降低（P〈0.05）,SLE病情活动指数（DAI）积分较无贫血组明显增高（P〈0.05）,而ACD和IDA患者合并白细胞减少者明显多于无贫血组患者（P〈0.05）,合并血小板减少和ANA滴度在AIHA、ACD和IDA患者均显著高于无贫血的SLE患者（P均〈0.05）.结论 SLE并发的贫血以ACD和IDA常见,其次为AIHA,且多见于活动性病情严重的患者.在不同类型的贫血患者并发白细胞和血小板减少者均高于无贫血患者,提示SLE中不同血细胞损害可能存在部分共同病理机制.     

乳酸亚铁片治疗妊娠合并缺铁性贫血52例报告

目的:探讨乳酸亚铁片治疗妊娠合并缺铁性贫血的疗效和安全性。方法:52例妊娠合并缺铁性贫血患者,轻度贫血患者予乳酸亚铁片0.1 bid,饭后口服,中度贫血予乳酸亚铁片0.2bid或tid饭后口服治疗。连续治疗4周后复查血常规。结果:50例患者均有不同程度的症状改善,例无效。结论:乳酸亚铁片治疗妊娠合并缺铁性贫血疗效良好,药物不良反应小。     

Aplastic anemia and pure red cell aplasia

Aplastic anemia (AA) is a disorder characterized by the presence of pancytopenia and a hypocellular bone marrow. Acquired pure red cell aplasia (PRCA), a part of a unique form of AA, is a rare condition of profound anemia characterized by the absence of reticulocytes and the virtual absence of erythroid precursors in the bone marrow. AA can be effectively treated by either stem cell transplantation or immunosuppressive therapy. However, PRCA has so far been treated by several different regimens which are largely empirically selected since so little control data are available. This issue focuses on the current progress in the treatment of acquired AA and PRCA.     

幽门螺杆菌相关性缺铁性贫血临床研究

目的：探讨幽门螺杆茵（helicobacter phlyori，Hp）感染与缺铁性贫血（iron deficiency anermia，IDA）的关系。方法：选择伴IDA、Hp感染阳性的慢性胃炎病人64例为观察组，慢性胃炎无贫血病人80例为对照组，均行快速尿素酶试验，内镜下组织病理检查；观察组Hp阳性病人分为A、B、C组，A组给予硫酸亚铁和抗Hp治疗，B组给予硫酸亚铁和安慰剂治疗，C组给予抗Hp治疗；观察治疗前后病人的血红蛋白（Hb）、红细胞计数（RBC）、平均红细胞容积（MCV）、网织红细胞（Ret）、血清铁（SI）、血清铁蛋白（SF）等血液学指标的变化。结果：观察组64例中60例Hp阳性，对照组80例中62例Hp阳性，两组间有极显著差异（P〈0．01）；观察组中A、C组与B组比较，治疗前后血液学指标改变厦疗效有显著差异（P〈0．05）。结论：Hp感染与IDA有一定相关性，抗Hp加铁剂是治疗Hp感染相关性缺铁性贫血的有效方法。