【实体器官移植后溶血性贫血的鉴别诊断与治疗】。

Urologiia i nefrologiia Pub Date : 1998-09-01
K von Appen
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引用次数: 0

摘要

大多数患者在实体器官移植后出现“贫血”的临床症状。多种病因导致红细胞计数减少——在不同的情况下,溶血是罪魁祸首。血栓性微血管病(溶血性尿毒症综合征、移植排斥或免疫抑制治疗引起的)、感染(细菌、病毒、真菌)和自身免疫反应(血型或恒河猴抗原的差异、药物诱导的红细胞溶解)是鉴别诊断步骤中需要考虑的最重要的病理。本文根据来自同一大学院系的三名移植患者的临床病史,描述了诊断、潜在病理和治疗结果的应用方法。因此,应将溶血作为器官移植后可能出现的重要情况予以考虑,立即追溯病因并进行有效治疗。
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[The differential diagnosis and therapy of hemolytic anemias after the transplantation of solid organs].

The clinical sign "anemia" is found in a majority of patients after solid organ transplantation. A variety of etiological factors cause reduced red blood counts--in different situations hemolysis is the culprit. Thrombotic microangiopathy (hemolytic uremic syndrome, transplant rejection or induced by immunosuppressive therapy), infections (bacterial, viral, fungal), and autoalloimmune reactions (differences in blood-group or Rhesus-antigens, drug induced RBC lysis) are most important pathologies to be considered in differential diagnostic steps. Methods applied in diagnostics, underlying pathologies and therapeutic consequences are described based on the clinical history of three transplant patients from a single university department. Therefore, hemolysis as a possible and important situation following organ transplantation should be considered, immediately traced back to the underlying disorder and effectively treated.

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