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[原发性骨髓纤维化患者大剂量甲泼尼龙治疗成功]

[Successful high-dose methylprednisolone therapy in a patient with primary myelofibrosis].

作者信息

Matsukawa Y, Ikeda E, Suguro H, Iizuka Y, Nishinarita S, Hayama T, Ohshima T, Sawada S, Horie T

机构信息

First Department of Internal Medicine, Nihon University School of Medicine.

出版信息

Rinsho Ketsueki. 1990 Oct;31(10):1674-9.

PMID:2174987
Abstract

We are presenting a patient with primary myelofibrosis who responded to the High-Dose methylprednisolone therapy (1 g/day for 3 days). Three and a half years ago, a 55-year-old male was admitted to our hospital because of severe erythroblastic anemia, thrombocytopenia, splenomegaly and "dry tap" of bone marrow aspiration. Bone marrow biopsy revealed a marked fibrosis without any blastoid cell proliferations. Since a thrombocytopenia was progressive and refractory to the ordinary therapy, high-dose methylprednisolone therapy was performed which was followed by an administration of activated vitamin D3. After the therapy, hematologic improvements were achieved within a month (RBC: 284 x 10(4)/microliters----413 x 10(4)/microliters, WBC: 3,000/microliters----11,500/microliters, Plat.: 7,000/microliters----20,000/microliters). Three months after the therapy, the bone marrow biopsy and 113In scintigraphy were performed. These tests also proved marked improvement of histological features of the bone marrow and a decrease of uptake of 113In to the spleen, respectively. The patient continues to be in good condition and he is free from any medications at present time.

摘要

我们报告一例原发性骨髓纤维化患者,其对大剂量甲泼尼龙治疗(1克/天,共3天)有反应。三年半前,一名55岁男性因严重的幼红细胞性贫血、血小板减少、脾肿大及骨髓穿刺“干抽”入住我院。骨髓活检显示明显纤维化,无任何母细胞样细胞增殖。由于血小板减少呈进行性且对常规治疗无效,遂进行大剂量甲泼尼龙治疗,随后给予活性维生素D3。治疗后,一个月内血液学指标得到改善(红细胞:284×10⁴/微升----413×10⁴/微升,白细胞:3000/微升----11500/微升,血小板:7000/微升----20000/微升)。治疗三个月后,进行了骨髓活检和¹¹³铟闪烁扫描。这些检查分别证实骨髓组织学特征明显改善以及¹¹³铟对脾脏摄取减少。患者目前状况良好,无需服用任何药物。

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