面部移植后与耐巨细胞病毒感染相关的吉兰-巴雷综合征
Guillain-Barré syndrome associated with resistant cytomegalovirus infection after face transplantation.
作者信息
Alhefzi M, Aycart M A, Bueno E M, Kueckelhaus M, Fischer S, Snook R J, Sharfuddin A A, Hadad I, Malla P, Amato A A, Pomahac B, Marty F M
机构信息
Division of Plastic Surgery, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Department of Neurology, Indiana University School of Medicine, Indianapolis, Indiana, USA.
出版信息
Transpl Infect Dis. 2016 Apr;18(2):288-92. doi: 10.1111/tid.12516.
A 39-year-old male, who received a facial allograft (cytomegalovirus [CMV] donor-seropositive, recipient-seronegative), developed multidrug-resistant CMV infection despite valganciclovir prophylaxis (900 mg/day) 6 months post transplantation. Lower extremity weakness with upper and lower extremity paresthesias developed progressively 11 months post transplantation, coinciding with immune control of CMV. An axonal form of Guillain-Barré syndrome was diagnosed, based on electrophysiological evidence of a generalized, non-length-dependent, sensorimotor axonal polyneuropathy. Treatment with intravenous immunoglobulin led to complete recovery without recurrence after 6 months.
一名39岁男性接受了面部同种异体移植（供体巨细胞病毒[CMV]血清学阳性，受体血清学阴性），尽管移植后6个月一直使用缬更昔洛韦预防治疗（900毫克/天），仍发生了耐多药CMV感染。移植后11个月逐渐出现下肢无力伴上下肢感觉异常，这与CMV的免疫控制同时发生。根据广泛性、非长度依赖性感觉运动性轴索性多发性神经病的电生理证据，诊断为轴索性吉兰-巴雷综合征。静脉注射免疫球蛋白治疗6个月后完全康复且未复发。
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