Coomb’s阳性的MDS病例报道及MDS的诊断思考

MDS是血液科的常见疾病，疾病的本质是①髓系的发育异常，即无效造血，临床表现为一系或多系的血细胞减少；②高危演变为急性髓系白血病，在骨髓象表现为原始细胞增多。并且还需要排除其他可能引起血细胞减少的疾病，这使得临床上诊断有一定困难。随着对疾病本质的深入理解及新分子诊断技术的应用，可以寻找更多MDS的证据，目前对MDS的诊断水平已经大大提高。但是在临床上仍有一些起初表现不典型，诊断十分困难的MDS，为早期治疗造成困难，现报道我们临床上收治的以Coomb’s阳性的自身免疫性溶血为早期表现，疾病进展迅速的MDS患者，以加强我们对MDS的疾病认识。

MDS case report with Coomb

MDS is a common disease in department of hematology, the nature of which is myeloid dysplasia (ineffective hematopoiesis) and high risk evolution to acute myloid leukemia. The manifestation of MDS is one or more kinds of hematocytopenia. And establish the diagnosis of MDS need to differential diagnosis with other disease that may cause hemotocytopenia, which makes it difficult to diagnose clinically. With the in-depth understanding of the nature of disease and the application of new molecular diagnostic techniques, more MDS evidence can be found, and the diagnostic level of MDS has been greatly improved. But there are still some MDS patients with atypical clinical manifestations initially, and the diagnosis is very difficult to establish MDS, then influent early treatment. In order to strengthen our understanding of diseases of MDS, now we report a special MDS case with the initial manifestations of autoimmune hemolytic with Coomb ''s positive, and rapid disease progression to AML.