[Rinshō ketsueki] The Japanese journal of clinical hematology
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Review Case Reports
[Non-Hodgkin's lymphoma associated with cold agglutinin disease].
Autoimmune hemolytic anemia (AIHA) complicated with non-Hodgkin's lymphoma (NHL) is not unusual. Two cases of NHL associated with cold agglutinin disease were reported. Case 1: A 38-year-old man had diffuse medium-sized cell NHL diagnosed by cervical lymph node biopsy. ⋯ The Hb was 8.2 g/dl with a cold agglutinin titer of 51,200, and an IgM level of 920 mg/dl (I specific), thus concurrent CAD was suspected. Biweekly COP-BLAM therapy was administered and CR was achieved along with a decrease in the cold agglutinin titer and improvement of her anemia. In both patients, the cold agglutinin titer decreased after CR was achieved suggesting that production of anti-erythrocyte autoantibody was due to disturbance of the antibody system by NHL.
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Review Case Reports
[Low titer cold agglutinin disease due to anti-HI antibody and a review of this disease in Japan].
A 79 year-old Japanese man was admitted because of brownish urine and Raynaud phenomenon. Laboratory data showed mild anemia with reticulocytosis, positive direct Coombs test against anti-C3, elevated level of lactate dehydrogenase, undetectable level of serum haptoglobin and low titer of cold agglutinin (1:256 at 4 degrees C), the immunoglobulin subclass of which was IgM. Cold agglutinin disease is usually associated with very high levels of cold agglutinins, the specificity of which is anti-I. This case had low titer cold agglutinin disease due to anti-HI cold agglutinin.
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Review Case Reports
[Management with antithrombin III concentrate in a pregnant woman with hereditary antithrombin III deficiency].
Pregnant women with hereditary antithrombin III (AT-III) deficiency are frequently associated with thromboembolic disorders. We have treated a pregnant woman with hereditary AT-III deficiency, who had suffered from thromboembolic disorders at her past three gestations, with AT-III concentrate. ⋯ In recent reports, pregnant women with hereditary AT-III deficiency had been treated with heparin or warfarin except for during abortion and delivery, in which time AT-III concentrate was widely utilized. But the use of heparin or warfarin during gestation is occasionally harmful, AT-III concentrate should be chosen for management in pregnancy in women with hereditary AT-III deficiency.