70 KB29 KB199420251998Černelč, Peterštevilka:3letnik:37str. 381-390ISSN:0025-8121COBISSID:9229785URN:URN:NBN:SI:doc-4KNFJTWDslMedicinski razglediMedicinski razglediAnemia, aplasticAnemia, hemolytic, autoimmuneAnemia, perniciousAutoimmune diseasesCoombs' testDiagnosisdiagnostikaHematologic diseaseshematologijaImmunologic diseasesImmunotherapyimunologijaimunske bolezniLeukemia, lymphocytic, acutelevkemijaTherapyPrikaz, ugotavljanje in zdravljenje nekaterih imunskih krvnih bolezni| Presentation, diagnosis and treatment of some immunohematologic diseases|Clinical hematology is the field of medicine most closely related to immunology, since pathologically aftered cells and other components of the immune response circulating in the blood form the basis of some hematological diseases. The author presents a female patient with acute lymptioblastic leukemia, anodier female patient suffering from autoimmune henpytic anemia, immune thrombocytopenia and pemicious anemia, and a male patient treated for aplastic anemia. Disorders characterized by malignant proliferation of cells involved in the immue response include acute lymphoblastic leukemia, malignantlymphomas and malignant immunoproliferative diseases. A patho- logically aftered immune response is associated with the appearance of antibodies which may be directed against erylhrocytes, platelets, neutrophils,coagulation factors, hemopoietic progenitor cells, parietal cells of the gastric mucosa or the intrinsic factor. The detection and, in particular, confirmation of an immune disorder often require the use of socalled immunological tests, which are based on individual reactions of the immune response. For the diagnosis of leukemias, malignant lymphomas and, in particular, subtypes of acute lymphoblastic leukemia, immunophenotyping of surface and cytoplasmic immunoglobulins is performed using flow cytometry. Oneof the oldest immunological investigations is the Coombs test for confirmation of autoimmune hemolytic anemia. Immune disorders are treated moreor less successtully with various immunosuppressive agents, such as corticosteroids, antilymphocyte globulin and cyclosporin. Only good knowledge of immune disorders and the methods used for their diagnosis can guarantee reliable prediction of the course of illness and its successful managementKlinična hematologija je področje medicine, ki je najtesneje povezano z imunologijo, saj so bolezensko spremenjene celice in druge sestavine imunskegaodziva, ki krožijo v krvnem obtoku, osnova nekaterim krvnim boleznim.Avtor predstavi bolnico z akutno limfoblaanemijo, imunsko trombocitopenijo in perniciozno anemijo ter bolnika z aplastično anemijo. Med bolezni, pri katerih je prisotna maligna rast celic imunskega odziva, uvrščarno akutno limfoblastno levkemijo, maligne limfome in maligne imunoproliferativne bolezni. Pri bolezensko spremenjenem imunskem odzivu se lahko pojavijo protitelesa proti eritrocitom, trombocitom, nevtrofilcem, dejavnikom koagulacije, krvotvomi matični celici, parietalnim celicam želodčnesluznice in intrinzičnemu dejavniku. Za prepoznavanje, predvsem pa za potrditev imunskih bolezni, po- gosto potrebujemo tako imenovane imunske preiskave, ki temeljijo na posameznih reakcijah imunskega odziva. Za opredelitev levkemij in malignih limfomov, posebno pa podvrst akutne limfoblastne levkemije, določamo membranske in citoplazemske imunoglobuline s pretočnim citometrom. Ena najstarejših imunskih preiskav je Coombsov preskus za potrditev avtoimunske hemolitične anemije. Imunske bolezni navadno zdravimoz različnim uspehom z glukokortikoidi, protilimfocitnim globulinom in ciklosporinom, ki zavirajo imunski odziv. Le dobro poznavanje temeljev imunskih bolezni in načinov ugotavljanja nam omogoča napovedati potek bolezni in načrtovati uspešno zdravljenjeTEXTznanstveno časopisjejournalsSlovenian National E-content AggregatorNational and University Library of SloveniaDruštvo Medicinski razgledi