Levy J, Wodell R A, August C S, Bayever E
Department of Pediatrics, University of Pennsylvania.
Bone Marrow Transplant. 1990 Nov;6(5):349-52.
Four weeks following autologous bone marrow transplantation for Wilms' tumor, a patient developed fever, hepatomegaly, coagulation disorders and pancytopenia. Bone marrow studies showed progressively increased hemophagocytosis of normal hematopoietic progenitors by histiocytes resulting in aplasia. Adenovirus type 11 was consistently isolated from urine and stool cultures, and one of the marrow aspirates. At autopsy, adenovirus was isolated from the lungs, liver, heart, intestine and spleen. These findings are consistent with the previously described virus-associated hemophagocytic syndrome, which have not been associated with bone marrow transplantation. This case suggests that this diagnosis should be considered in any bone marrow transplant patient who has evidence of secondary graft failure.
一名患有肾母细胞瘤的患者在接受自体骨髓移植四周后，出现发热、肝肿大、凝血功能障碍和全血细胞减少。骨髓检查显示，组织细胞对正常造血祖细胞的噬血细胞作用逐渐增强，导致再生障碍。从尿液、粪便培养物以及一份骨髓穿刺物中持续分离出11型腺病毒。尸检时，从肺、肝、心、肠和脾中分离出腺病毒。这些发现与先前描述的病毒相关噬血细胞综合征一致，该综合征此前与骨髓移植无关。该病例表明，对于任何有继发性移植物衰竭证据的骨髓移植患者，都应考虑这一诊断。
