Jakobovich E, Koplewitz B, Marva E, Granot E
Kaplan Medical Center, Rehovot, Israel.
Department of Medical Imaging, Hadassah Hebrew University Medical Center, Jerusalem, Israel.
Case Rep Transplant. 2014;2014:923058. doi: 10.1155/2014/923058. Epub 2014 Jul 14.
We describe a 14-year-old girl, who was 13 y after liver transplantation for biliary atresia with an unremarkable postoperative course. She presented with fever of up to 40°C, extreme fatigue, malaise, anorexia, and occasional vomiting. On physical examination the only finding was splenomegaly. Lab results showed hyperglobulinemia and an elevated sedimentation rate. Liver function tests were normal except for mild elevation of γGTP. Abdominal U/S and CT demonstrated an enlarged spleen with retroperitoneal and mesenteric lymph nodes enlargement. An exhaustive evaluation for infectious causes, autoimmune conditions, and malignancy was negative. A full recovery after 5 months prompted testing for self-limited infectious etiologies. Yersinia enterocolitica infection was diagnosed.
我们描述了一名14岁女孩,她在因胆道闭锁接受肝移植术后13年,术后病程平稳。她出现了高达40°C的发热、极度疲劳、不适、厌食和偶尔呕吐的症状。体格检查唯一的发现是脾肿大。实验室检查结果显示球蛋白血症和血沉升高。肝功能检查除γ-谷氨酰转肽酶轻度升高外均正常。腹部超声和CT显示脾脏肿大,伴有腹膜后和肠系膜淋巴结肿大。对感染原因、自身免疫性疾病和恶性肿瘤进行的全面评估均为阴性。5个月后完全康复促使对自限性感染病因进行检测。诊断为小肠结肠炎耶尔森菌感染。