论文部分内容阅读
毛细胞白血病是一种罕见的疾病,通常会出现全血细胞减少和脾肿大,但并不伴有淋巴系统的病变。毛细胞白血病息者一般病程较长,其中数生存期约5年,但也有存活20年以上和自发缓解者的报道。本文报告的4例毛细胞白血病患者,其外周血,骨髓或脾脏标本的形态学观察和细胞化学染色检查均确证为本病。这些患者在确诊为毛细胞白血病的两年内出现了象多发性结节性动脉炎那样的全身性血管炎。该4例患者均为男性白人,年龄为34～53岁。其中3例患者曾作脾切除术,都是在切脾术后一年内并发动脉炎。本组患者在出现血管炎的初期均进行了充分的研究。2例病人做了血管造影,显示出有多处小动脉瘤(肠系膜、下肢、肝、肾)存在。3例进行组织活检,均发现有中等动脉的坏死性血管炎病变,结合临床表现,从而证实了多发性结节性动脉炎的诊断。多发性结节性动脉炎的病因以往报导多由药物过敏、特异性反应、自家过敏反应和感染所致。本组4例病人虽曾都有过轻中度不同程度的感染,并使用过抗菌素和其他有关药物进行治疗,所有病人也都输过血,但经对其感染等进行充分研究和类风湿因子、抗
Hairy cell leukemia is a rare disease, usually with pancytopenia and splenomegaly, but not with lymphatic system lesions. Hair loss leukemia patients generally longer course, the number of survival of about 5 years, but there are also more than 20 years of survival and spontaneous remission were reported. In this paper, 4 cases of hairy cell leukemia patients, the peripheral blood, bone marrow or spleen specimens were observed morphologically and cytochemical staining were confirmed as the disease. These patients developed systemic vasculitis, such as multiple nodular arteritis, within two years of diagnosis of hairy cell leukemia. The 4 patients were all male white, aged 34 to 53 years. Three of the patients had splenectomy, all with arteritis within one year after splenectomy. This group of patients in the early stages of vasculitis have been fully studied. Two patients underwent angiography, showing multiple small aneurysms (mesentery, lower extremity, liver, kidney). 3 cases of tissue biopsy were found in moderate artery necrotizing vasculitis lesions, combined with clinical manifestations, which confirmed the diagnosis of multiple nodular arteritis. The causes of multiple nodular arteritis in the past reported by the drug allergy, specific reactions, their own allergic reactions and infections. Although 4 patients in this group had mild to moderate degree of different degrees of infection, and used antibiotics and other related drugs for treatment, all patients have also been transfused, but after the full study of their infection and rheumatoid factor ,anti