一例自体外周血干细胞移植后发生的硬皮病样移植物抗宿主病。

A case of sclerodermatous graft-versus-host disease following autologous peripheral blood stem cell transplantation.

作者信息

Nakamura Koichiro, Kawakami Yoshio, Oyama Noritaka, Kaneko Fumio, Abe Hiroyuki, Sagara Hiroya, Ohto Hitoshi

机构信息

Department of Dermatology, Fukushima Medical University School of Medicine, Fukushima, Japan.

出版信息

J Dermatol. 2006 Feb;33(2):135-8. doi: 10.1111/j.1346-8138.2006.00029.x.

DOI:10.1111/j.1346-8138.2006.00029.x

PMID:16556284

Abstract

We report a 65-year-old woman with chronic graft-versus-host disease (GVHD) who developed severely sclerotic skin on the fingers, hand and trunk following autologous peripheral blood stem cell transplantation (APBSCT). The patient had suffered from breast cancer and been treated with surgery and chemotherapy. She showed pancytopenia and was treated with APBCST. Four years after APBSCT, she developed the severe sclerotic changes on the fingers, hands, extremities and trunk. The skin biopsy showed a flattened epidermis and a proliferation of collagen bundles in the dermis. No anti-nucleolar DNA titers were detected in the serum. She was diagnosed with chronic GVHD. Despite treatment with oral prednisolone, the skin sclerotic change developed and the breast cancer recurred. She died due to pericarditis. This is a rare case of sclerodermatous GVHD following APBSCT. The serum interleukin (IL)-12 levels were examined during the treatment.

摘要

我们报告一例65岁患有慢性移植物抗宿主病（GVHD）的女性患者，她在自体外周血干细胞移植（APBSCT）后手指、手部和躯干出现严重的皮肤硬化。该患者曾患乳腺癌并接受过手术和化疗。她出现全血细胞减少并接受了APBCST治疗。APBSCT四年后，她的手指、手部、四肢和躯干出现严重的硬化改变。皮肤活检显示表皮扁平，真皮中胶原束增生。血清中未检测到抗核仁DNA滴度。她被诊断为慢性GVHD。尽管口服泼尼松龙治疗，皮肤硬化改变仍进展，且乳腺癌复发。她因心包炎死亡。这是APBSCT后硬皮病样GVHD的罕见病例。治疗期间检测了血清白细胞介素（IL）-12水平。