13 下列何種疾病因脾臟功能亢進而以脾臟切除（splenectomy）進行治療效果最不彰？

遺傳性球型紅血球症（hereditary spherocytosis）

重型乙型海洋性貧血（β-thalassemia major）

慢性原發性血小板過低紫斑症（chronic idiopathic thrombocytopenic purpura）

冷凝素疾病（cold agglutinin disease）

ANS D

Cold agglutinin disease is an autoimmune disease characterized by the presence of high concentrations of circulating antibodies, usually IgM, directed against red blood cells.^[1] It is a form of autoimmune hemolytic anemia, specifically one in which antibodies only bind red blood cells at low body temperatures, typically 28-31°C.

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15 有關免疫抑制藥物的機轉，何者為誤？

 Etanercept 主要的作用是抑制介白質-1（IL-1）所引起的發炎

用在全身性紅斑狼瘡的Hydroxychloroquine 原來是用來治療瘧疾

靜脈注射的免疫球蛋白除了對川崎氏症有效外，也可以用來治療皮肌炎

 Sulfasalazine 主要是用來治療幼年型類風濕關節炎

ANS A

Etanercept (trade name Enbrel) is a drug that treats autoimmune diseases by interfering with the tumor necrosis factor (TNF, a part of the immune system) by acting as a TNF inhibitor