摘要
近期,我们收到1例不寻常的血清样本:患者的血清量异常偏少,与其全血容量比例失衡——这一现象在现有诸多研究中常被报道与多发性骨髓瘤有关,其中患者的免疫球蛋白异常增多为主要原因,但该患者经影像等其他诊断手段被确诊为肺动静脉瘘(pulmonary arteriovenous fistula,PAVF)。在本案例中,将指出肺动静脉瘘患者的样本同样具有血清量异常减少的表象,揭示其病理原因,并给出其实验室检验诊断特征如红细胞、血红蛋白增多(RBC、Hb)以及溶血标志物升高(LDH、TBIL)等。本研究将有助于临床检验人员加深对肺动静脉瘘患者样本的认识,提高对其典型检验指标的理解,防止误诊。
Recently,we encountered an unusual serum sample from a patient with disproportionately low serum volume relative to whole blood volume.While this phenomenon is frequently associated with multiple myeloma(attributed to immunoglobulin overproduction),imaging studies confirmed a diagnosis of pulmonary arteriovenous fistula(PAVF)in this case.With this case study,we demonstrate that PAVF can mimic the laboratory presentation of reduced serum volume,elucidate its pathological mechanisms(e.g.compensatory erythrocytosis and hemolysis),and summarize characteristic laboratory findings,including elevated red blood cells(RBC),hemoglobin(Hb),lactate dehydrogenase(LDH),and total bilirubin(TBIL).This case report underscores the importance of recognizing PAVF-specific laboratory patterns to avoid potential misdiagnosis and to better guide the differential diagnosis.
作者
田歌
周茜宁
冯杰
高艳红
TIAN Ge;ZHOU Xining;FENG Jie;GAO Yanhong(Department of Clinical Laboratory,The First Medical Center of PLA General Hospital,Beijing 100853,China)
出处
《标记免疫分析与临床》
2025年第5期1083-1088,共6页
Labeled Immunoassays and Clinical Medicine
基金
国家重点研发计划项目子课题(编号:2017YFF0205401)。
关键词
肺动静脉瘘
血清量异常偏少
典型检验指标
鉴别诊断
Pulmonary arteriovenous fistula(PAVF)
Decreased serum volume
Typical laboratory markers
Differential diagnosis
