表现酷似再生障碍性贫血的急性造血停滞23例临床分析

目的报告表现酷似重型再生障碍性贫血（SAA）的急性造血停滞（AAH）患者临床特征，探讨与SAA和极重型再生障碍性贫血（vSAA）患者的鉴别。方法以111例初治SAA和vSAA患者为对照，回顾性分析23例临床表现酷似再生障碍性贫血的AAH患者临床及实验室特征。结果23例从H中16例临床及实验室检查符合SAA或vSAA诊断标准，自发病起2个月内出现自发性造血恢复，中位时间为17（8-40）d。与对照组患者比较，符合SAA或vSAA诊断标准的16例AAH患者年龄大中位年龄35．5岁，SAA（包括vSAA）为21.0岁]，多伴有其他疾病及用药史，常以发热症状起病；实验室检查与SAA或vSAA相似，但低血清白蛋白发生率高，总铁结合力减低更为常见，骨髓CFU-GM相对较高。结论某些AAH与SAA或vSAA临床表现非常相似，常需回顾性诊断方可鉴别，分析其起病情况及实验室特征有助于早期识别。

Acute arrest of hemopoiesis mimics aplastic anemia: 23 cases report

OBJECTIVE: To reveal the clinical features of patients with acute arrest of hemopoiesis (AAH), and explore the dissimilarity between AAH, severe aplastic anemia (SAA) and very severe aplastic anemia (vSAA). METHODS: The clinical and laboratory features of 23 AAH patients diagnosed and treated in our hospital from May 1993 to May 2006 were analysed retrospectively and compared to the 111 cases of SAA and vSAA patients diagnosed at anaemia therapeutic centre of the hospital from Jul 2002 to May 2006. RESULTS: Twenty-three patients accorded with the criteria for AAH, and 16 of them with the criteria for severe acute arrest of hemopoiesis (SAAH). They could spontaneously reconstitute their bone marrow hematopoiesis at a median of 17 days (range, 8-50), and had remarkable older age (median age 35.5 vs 21), positive history of other disease and taking medication. Fever as one of presenting symptom were noticed in 10 of 16 STAA patients. The laboratory results were similar with SAA or vSAA, had more frequent decreased serum albumin level and total iron binding capacity and higher CFU-GM. CONCLUSIONS: Patients with AAH often had similar clinical symptoms with SAA or vSAA. Although they were diagnosed retrospectively, identification of the pathogenesis and laboratory examination may help for the early diagnosis.