Kawakami Takako, Mitsui Tetsuo, Sendo Dai, Kanazawa Chikako, Maeda Shoko, Katsuura Michihiko, Shimizu Yukitoshi, Yokoyama Shinkichi
Department of Pediatrics, Yamagata University School of Medicine.
Rinsho Ketsueki. 2002 Mar;43(3):176-82.
To clarify the frequency and cause of acute pancreatitis following hematopoietic stem cell transplantation (SCT), we examined retrospectively 57 patients who underwent hematopoietic SCT in our institute from 1984 to 2000. Twelve (21%) of the patients showed an elevated level of serum pancreatic amylase following SCT. However, only 3 patients were clinically diagnosed as having acute pancreatitis. Among these 12 patients, 11 had undergone allogeneic transplantation. Furthermore, patients who had undergone unrelated transplantation (7/16; 44%) tended to show a higher incidence of increased amylase than those who had undergone related transplantation (4/24; 17%). Six patients were at an advanced stage of acute GVHD (grade III or IV) and all showed an elevated level of serum amylase, whereas only four patients showed an elevated serum amylase level among 34 with mild acute GVHD (grade I or II) or without GVHD. Furthermore, five out of 12 patients who showed an increased amylase level were concurrently diagnosed as having viral infection such as cytomegalovirus, adenovirus, or varicella zoster virus. We conclude that pancreatitis following SCT occurs more often than realized, and is mostly subclinical. This is closely associated with severe acute GVHD, and possibly viral infection.
为明确造血干细胞移植（SCT）后急性胰腺炎的发生率及病因，我们回顾性研究了1984年至2000年间在我院接受造血干细胞移植的57例患者。12例（21%）患者在SCT后血清胰淀粉酶水平升高。然而，只有3例患者临床诊断为急性胰腺炎。在这12例患者中，11例接受了异基因移植。此外，接受非亲缘移植的患者（7/16；44%）淀粉酶升高的发生率往往高于接受亲缘移植的患者（4/24；17%）。6例处于急性移植物抗宿主病（GVHD）晚期（III或IV级），均表现出血清淀粉酶水平升高，而在34例轻度急性GVHD（I或II级）或无GVHD的患者中，只有4例血清淀粉酶水平升高。此外，12例淀粉酶水平升高的患者中有5例同时被诊断为患有巨细胞病毒、腺病毒或水痘带状疱疹病毒等病毒感染。我们得出结论，SCT后胰腺炎的发生率比我们意识到的更高，且大多为亚临床型。这与严重急性GVHD密切相关，也可能与病毒感染有关。
