摘要
本文报道1例15岁的重型β地中海贫血女性患儿,从出生6个月开始依赖输血治疗,且输血需求随着年龄增长而增加.患儿15岁开始接受沙利度胺治疗,治疗1个月后,完全脱离输血,血红蛋白水平维持在98～109 g·L-1,但在沙利度胺治疗第11个月时出现头晕和疲劳症状、血红蛋白下降,间接抗球蛋白试验和直接抗球蛋白试验阳性,诊断为新发的自身免疫性溶血性贫血,考虑与沙利度胺相关,不良反应关联性评价为"很可能".经停药、糖皮质激素治疗后,间接抗球蛋白试验和直接抗球蛋白试验转为阴性.本病例提示,使用沙利度胺治疗地中海贫血患者应定期进行直接抗球蛋白试验和间接抗球蛋白试验,监测自身免疫性溶血性贫血的发生.
Abstract
This paper reported a 15-year-old girl with β-thalassemia major became dependent on blood transfusions from 6 months after birth whose blood transfusion needs increased with age.The girl started treatment with thalidomide at the age of 15.She became transfusion independent one month after starting thalidomide treatment,and her hemoglobin levels were maintained at 98-109 g·L-1.However,the girl subsequently developed symptoms of dizziness and fatigue in the 11th month of thalidomide treatment.Her hemoglobin was decreased and indirect antiglobulin test and direct antiglobulin test were positive.She was diagnosed with new onset autoimmune hemolytic anemia,which was considered to be related to thalidomide,and the association of adverse reactions was evaluated as"possible".Indirect antiglobulin test and direct antiglobulin test were negative after drug withdrawal and glucocorticoid therapy.Therefore,patients with thalassemia who are treated with thalidomide should be carefully monitored for the development of autoimmune hemolytic anemia.
维普
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