COOMBS-POSITIVE HEMOLYTIC DISEASE IN MALARIA
COOMBS-POSITIVE HEMOLYTIC DISEASE IN MALARIA
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DOI：
10.7326/0003-4819-68-1-33
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发表时间：
1968-01-01
影响因子：
39.2
通讯作者：
CONRAD, ME
中科院分区：
文献类型：
--
作者：
ADNER, MM;ALTSTATT, LB;CONRAD, ME
在131名士兵撤离越南与抗药性恶性疟原虫疟疾。4例直接抗球蛋白试验阳性，均为IG G型。在3例患者中，Coombs试验阳性似乎与复发性疟疾的奎宁给药时间相关，并与溶血有关。其中2例患者出现奎宁相关皮炎，1例患者在奎宁治疗开始后1小时内出现黑水热，另1例患者在无奎宁红细胞洗脱液中出现Panag-Alcohol。第4例患者发生代偿性溶血，直接Coombs试验阳性，似乎与奎宁治疗无关。所有受试者的间接Coombs试验均为阴性，血清或红细胞洗脱液中未发现抗奎宁抗体。Coombs阳性溶血病是疟疾感染的一种罕见并发症。对人体的临床观察表明，奎宁在溶血反应中具有因果作用。该药物诱导溶血发生的机制尚不清楚。
In 131 soldiers evacuated from Vietnam with drug resistant Plasmodium falciparum malaria. 4 patients were found with a positive direct anti-globulin test of the Ig G type. In 3 patients, the positive Coombs tests seemed temporally related to the administration of quinine for relapsed malaria and were associated with hemolysis. Two of these patients had a quinine related dermatitis, 1 developed blackwater fever within hr. after the initiation of quinine therapy and another had a panag-glutinin in quinine-free red cell eluates. The 4th patient had compensated hemolysis and a positive direct Coombs test which seemed unrelated to quinine therapy. The indirect Coombs test was negative in all subjects and no antiquinine antibodies were found in sera or red cell eluates. Coombs-positive hemolytic disease is an unusual complication of malarious infections. Clinical observations in man suggest that quinine has a causal role in the hemolytic reaction. The mechanism by which this drug induced hemolysis occurs is not known.