美法仑是自体造血干细胞移植期间急性脑病的罪魁祸首还是混淆因素？
Melphalan Culprit or Confounder in Acute Encephalopathy during Autologous Hematopoietic Stem Cell Transplantation?
作者信息
Alayón-Laguer Diógenes, Alsina Melissa, Ochoa-Bayona Jose L, Ayala Ernesto
机构信息
Hematology-Oncology Program San Juan City Hospital and VA Caribbean Healthcare System, 10 Calle Casia, San Juan, PR 00921, USA.
出版信息
Case Rep Transplant. 2012;2012:942795. doi: 10.1155/2012/942795. Epub 2012 May 7.
Abstract
We report a case of a female patient with Durie-Salmon stage 3A/ISS stage I IgG kappa multiple myeloma (MM) who developed encephalopathy after high-dose melphalan and hematopoietic stem cell transplant (HSCT). The most common etiologies for encephalopathy such as infection, narcotic medications, metabolic-electrolyte disturbance, stroke, and central nervous system (CNS) hemorrhages were ruled out. The patient recovered from the altered mental status spontaneously. The possibilities of melphalan-induced encephalopathy versus critical-state delirium versus hypercytokinemia induce encephalopathy were contemplated.
摘要
我们报告了一例Durie-Salmon 3A期/国际分期系统（ISS）I期IgG κ型多发性骨髓瘤（MM）女性患者，其在接受大剂量美法仑和造血干细胞移植（HSCT）后发生了脑病。脑病最常见的病因，如感染、麻醉药物、代谢电解质紊乱、中风和中枢神经系统（CNS）出血，均被排除。患者的精神状态改变自行恢复。我们考虑了美法仑诱发的脑病、危重症谵妄与高细胞因子血症诱发脑病的可能性。
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