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一名接受维持治疗的急性淋巴细胞白血病患儿发生巨细胞病毒性视网膜炎,经静脉注射更昔洛韦成功治愈。

Cytomegalovirus Retinitis in an ALL Child during Maintenance Therapy Treated Successfully with Intravenous Ganciclovir.

作者信息

Celiker Hande, Karaaslan Ayse, Kepenekli Kadayifci Eda, Atici Serkan, Soysal Ahmet, Kazokoglu Haluk, Koc Ahmet

机构信息

Department of Ophthalmology, Marmara University School of Medicine, Istanbul, Turkey.

Department of Pediatrics, Marmara University School of Medicine, Istanbul, Turkey.

出版信息

Case Rep Ophthalmol Med. 2014;2014:294238. doi: 10.1155/2014/294238. Epub 2014 Aug 3.

Abstract

Purpose. In here we described cytomegalovirus retinitis (CMVR) in 12-year-old male patient with acute lymphoblastic leukemia (ALL) who was on maintenance phase therapy. Methods. He was referred to our clinic for seeing of spots with the right eye for 3 days. At presentation, his best corrected visual acuity was 20/20 in the right eye and 20/20 in the left eye. Slit-lamp biomicroscopic examination of the anterior chamber of the left eye was within normal limits, whereas we observed 3+ anterior chamber cellular reaction in the right eye. On retinal examination, we found active retinitis lesions (cream-colored lesions associated with hemorrhages) and perivascular cuffing in the retinal periphery in the right eye. Left eye was normal. Results. On the basis of clinical picture, we made the diagnosis of CMVR in the right eye. Vitreous aspiration was performed and 23096 copies/mL of CMV DNA was detected by polymerase chain reaction (PCR) technique. The patient was successfully treated with intravenous ganciclovir for two weeks and discharged with oral valganciclovir prophylaxis. Conclusion. CMVR should be in mind in children with ALL on maintenance phase therapy even in those without hematopoietic stem cell transplantation. These patients can be treated successfully by intravenous ganciclovir alone.

摘要

目的。在此,我们描述了一名12岁处于急性淋巴细胞白血病(ALL)维持期治疗的男性患者的巨细胞病毒性视网膜炎(CMVR)。方法。他因右眼出现斑点3天前来我们诊所就诊。就诊时,他右眼的最佳矫正视力为20/20,左眼为20/20。左眼眼前房的裂隙灯生物显微镜检查在正常范围内,而右眼我们观察到3+的前房细胞反应。视网膜检查时,我们在右眼视网膜周边发现了活动性视网膜炎病变(与出血相关的奶油色病变)和血管周围套袖状浸润。左眼正常。结果。根据临床表现,我们诊断右眼为CMVR。进行了玻璃体抽吸,并通过聚合酶链反应(PCR)技术检测到23096拷贝/毫升的CMV DNA。患者接受静脉注射更昔洛韦治疗两周,成功治愈,并出院口服缬更昔洛韦预防。结论。对于处于ALL维持期治疗的儿童,即使没有进行造血干细胞移植,也应考虑到CMVR。这些患者单独使用静脉注射更昔洛韦即可成功治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9cfd/4137609/7ad1ec15647f/CRIOPM2014-294238.001.jpg

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