Gondo H, Okamura C, Osaki K, Shimoda K, Asano Y, Okamura T
Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan.
Bone Marrow Transplant. 2000 Dec;26(11):1255-7. doi: 10.1038/sj.bmt.1702682.
A 38-year-old Japanese woman with severe aplastic anemia received an allogeneic bone marrow transplant from her serologically HLA-identical father. Cyclosporine and methotrexate were administered to prevent graft-versus-host disease (GVHD). However, grade III acute GVHD developed on day 44, which was successfully treated with methylprednisolone and tacrolimus. Fluconazole therapy was started for oral candidiasis on day 112, but she complained of headache soon after. In addition to glycosuria and increased serum creatinine levels, Pelger-Huët anomaly of granulocytes was found in her blood, which disappeared after discontinuation of tacrolimus. Transient occurrence of Pelger-Huët cells may be associated with tacrolimus toxicity due to drug interaction with fluconazole.
一名38岁的日本重症再生障碍性贫血女性接受了来自血清学上HLA匹配的父亲的异基因骨髓移植。给予环孢素和甲氨蝶呤以预防移植物抗宿主病（GVHD）。然而，在第44天发生了III级急性GVHD，通过甲基泼尼松龙和他克莫司成功治疗。在第112天开始使用氟康唑治疗口腔念珠菌病，但她随后不久就抱怨头痛。除了糖尿和血清肌酐水平升高外，在她的血液中发现了粒细胞的Pelger-Huët异常，在停用他克莫司后消失。Pelger-Huët细胞的短暂出现可能与他克莫司与氟康唑的药物相互作用导致的毒性有关。
