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目的:探讨免疫相关性血细胞减少(IRH)症误诊原因以及相混淆的疾病种类以及临床特点。方法:对IRH28例患者的临床表现、血常规、网织红细胞(R et)计数、库姆试验(Coom bs)、抗血小板抗体、中性粒细胞抗体、骨髓细胞形态、骨髓病理、骨髓单个核细胞抗体等检测结果和相混淆疾病进行比较、分析、疾病划分和鉴别。结果:误诊为Coom bs阴性的免疫性溶血性贫血(A IHA)2例,免疫性血小板减少性紫癜(ITP)2例,粒细胞减少症4例,Evans综合征8例,早期再生障碍性贫血(AA)12例。结论:IRH/IRP与A IHA、ITP、粒细胞减少症、Evans综合征以及早期AA相比,临床表现、发病机制虽有相似之处,但对未成熟血细胞抗体的检验是减少误诊的关键。
Objective: To investigate the causes of misdiagnosis of immune-associated cytopenias (IRH) and the types of diseases that are confused and their clinical features. Methods: The clinical manifestations, blood routine, reticulocyte count (R et), Coombs test, antiplatelet antibody, neutrophil antibody, bone marrow cell morphology, myelopathies, bone marrow mononuclear cells Cell antibodies and other test results and confused disease comparison, analysis, disease classification and identification. Results: Misdiagnosed as Coombs negative immune hemolytic anemia (A IHA) in 2 cases, immune thrombocytopenic purpura (ITP) in 2 cases, neutropenia in 4 cases, Evans syndrome in 8 cases, early aplastic anemia (AA) in 12 cases. CONCLUSION: Although there are similarities in clinical manifestations and pathogenesis between IRH / IRP and A IHA, ITP, neutropenia, Evans syndrome and early AA, the detection of immature blood cell antibodies is the key to reduce misdiagnosis.