Scholl S, Hocke M, Hoffken K, Sayer H G
Department of Internal Medicine II (Oncology/Hematology/Gastroenterology/Infectious Disease), Medical Faculty, Friedrich Schiller University, Jena, Germany.
Acta Haematol. 2006;116(1):58-61. doi: 10.1159/000092349.
We report on a 54-year-old male patient with an aggressive T cell non-Hodgkin's lymphoma with abdominal manifestation undergoing autologous peripheral blood stem cell transplantation after high-dose chemotherapy in April 2003. About 4 months after transplantation, he developed severe upper abdominal pain. Ultrasound examination, X-ray, computed tomography of the abdomen and cardiac diagnostics could not explain the symptoms. While empiric therapy with high-dose acyclovir was started, we could document herpetic lesions in the gastric antrum by endoscopy. The epigastric pain rapidly decreased within several days after the start of acyclovir therapy. No herpetic skin lesions were observed at any time during the disease. This report demonstrates the importance of viral-induced gastritis in the differential diagnosis of severe abdominal pain in patients receiving autologous peripheral blood stem cell transplantation.
我们报告了一名54岁男性患者，其患有侵袭性T细胞非霍奇金淋巴瘤并伴有腹部表现，于2003年4月在大剂量化疗后接受了自体外周血干细胞移植。移植后约4个月，他出现了严重的上腹部疼痛。超声检查、X线、腹部计算机断层扫描及心脏诊断均无法解释这些症状。在开始使用大剂量阿昔洛韦进行经验性治疗时，我们通过内镜检查在胃窦发现了疱疹性病变。阿昔洛韦治疗开始后数天内，上腹部疼痛迅速减轻。在疾病过程中的任何时候均未观察到疱疹性皮肤病变。本报告证明了病毒诱导的胃炎在接受自体外周血干细胞移植患者严重腹痛的鉴别诊断中的重要性。
