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신이식후 발생한 자가면역 용혈성 빈혈의 임상적 고찰 |
전희경 , 박정희 , 이승헌 , 양철우 , 김용수 , 구완서 , 최의진 , 윤영석 , 방병기 |
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Abstract |
In order to investigate the prevalence and clinical course of autoimmune hemolytic anemia (AIHA) we evaluated retrospectively 729 renal transplant reci- pients. Results were as follows: 1) Incidence of AIHA according to ABO-minor -incompatiblity was 8.0%(13/163). 2) Blood group of all donors was 0 type and that of recipients was A type(10/64; 15.6%), AB type(1/15; 6. 7%) and B type (2/47, 4.3%) 3) AIHA occur 13.3±4.6 days (range; 8-25) after renal transplantation and continue for 12.8±6.8 days (range; 3-26). 4) Laboratory finding was variable according to clinical severity. 5) Treatment of AIHA was made according to the severity of AIHA; no treatment (3cases), azathioprine alone (4 cases), combination therapy of azathioprine and plasmapheresis (6 cases). 6) Clinical course of AIHA was favorable in 12 cases except one expired case due to fulminant hemolytic crisis. In conclusion, nephrologist must alert to unexpected reduction in hematocrit or other signs of hemolysis in the early posttasnsplant period, especially in ABO-minor-incompatible recipients. Careful follow -up of laboratory finding and early treatment of AIHA may be necessary to prevent fatal hemolytic crisis. |
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