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儿童急性淋巴细胞白血病继发播散性毛霉菌病伴甲状腺功能亢进症:病例报告及文献复习。

Hyperthyroidism secondary to disseminated mucormycosis in a child with acute lymphoblastic leukemia: case report and a review of published reports.

机构信息

Department of Pediatrics, Hematology, Oncology and Endocrinology, Medical University of Gdansk, Debinki 7, 80-211, Gdansk, Poland.

出版信息

Mycopathologia. 2013 Feb;175(1-2):123-7. doi: 10.1007/s11046-012-9584-1. Epub 2012 Sep 25.

Abstract

Thyroiditis due to fungal infection is an extremely rare cause of hyperthyroidism. The most common etiological factor of thyroiditis is Aspergillus. Infections due to members of the Mucorales have been an increasing clinical problem in recent years, and the prognosis in generalized infections due to those fungi is usually very poor. No hyperthyroidism in a child with thyroiditis due to mucormycosis has been reported in the literature so far. We describe a clinical course of generalized mucormycosis with thyroid involvement in a 12-year-old girl treated for acute lymphoblastic leukemia. The child underwent a hyperthyroidism connected with thyroid involvement due to a fungal process. The diagnosis was based on the clinical signs, laboratory findings and typical ultrasound scan; however, later attempt to amplify the fungi DNA from the tissue block has failed. The child died because of multiorgan failure due to general fungal infection 49 days after the invasive fungal infection was diagnosed. The generalized mucormycosis is always connected with poor prognosis and the mortality is high.

摘要

真菌性甲状腺炎导致的甲状腺功能亢进症极为罕见。最常见的甲状腺炎病因是曲霉菌。近年来,毛霉目成员导致的感染已成为日益严重的临床问题,这些真菌所致全身性感染的预后通常非常差。文献中尚无儿童毛霉病性甲状腺炎导致甲状腺功能亢进症的报道。我们描述了一例 12 岁女孩在接受急性淋巴细胞白血病治疗过程中发生的伴甲状腺受累的全身性毛霉病的临床经过。该患儿发生了与真菌性疾病相关的甲状腺受累所致的甲状腺功能亢进症。该诊断基于临床体征、实验室检查和典型超声扫描结果;然而,后来尝试从组织块中扩增真菌 DNA 的尝试失败了。患儿在侵袭性真菌感染诊断后 49 天因多器官功能衰竭而死亡。全身性毛霉病总是与不良预后相关,死亡率很高。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/24af/3550700/f939818049b4/11046_2012_9584_Fig1_HTML.jpg

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