一名正在接受化疗的患者出现无痛性中性粒细胞减少性小肠结肠炎。
Painless neutropenic enterocolitis in a patient undergoing chemotherapy.
作者信息
Chow E J, Bishop K D
机构信息
Departments of Medicine and Pediatrics, Warren Alpert Medical School of Brown University, Rhode Island Hospital, and Hasbro Children's Hospital, Providence, RI, U.S.A.
Department of Medicine, Division of Hematology and Oncology, Warren Alpert Medical School of Brown University, Providence, RI, U.S.A.
出版信息
Curr Oncol. 2016 Oct;23(5):e514-e516. doi: 10.3747/co.23.3119. Epub 2016 Oct 25.
CASE DESCRIPTION
A 60-year-old man developed painless neutropenic enterocolitis after induction chemotherapy for newly diagnosed acute myelogenous leukemia. The patient had recurrent fever while neutropenic, without experiencing abdominal pain or tenderness on physical examination. His diagnosis was delayed by the fact that he had no localizing symptoms.
DISCUSSION
Neutropenic enterocolitis is a common complication, generally occurring in patients who are severely neutropenic; the condition presents with fever and abdominal pain. No cases of painless neutropenic enterocolitis have yet been reported. Review of the literature shows that patients can develop this condition in the absence of fever and, sometimes, neutropenia. Furthermore, few comprehensive studies or reviews have investigated the utility of computed tomography imaging in identifying a source for abdominal pain in neutropenic patients with fever.
SUMMARY
Many potential causes of febrile neutropenia should be considered in chemotherapy patients.
病例描述
一名60岁男性在新诊断的急性髓系白血病诱导化疗后发生无痛性中性粒细胞减少性小肠结肠炎。患者在中性粒细胞减少期间反复发热，体格检查时未出现腹痛或压痛。由于他没有定位症状，诊断被延误。
讨论
中性粒细胞减少性小肠结肠炎是一种常见并发症，通常发生在严重中性粒细胞减少的患者中；该病症表现为发热和腹痛。尚未有无痛性中性粒细胞减少性小肠结肠炎的病例报道。文献回顾显示，患者可在无发热甚至有时无中性粒细胞减少的情况下发生这种病症。此外，很少有全面的研究或综述探讨计算机断层扫描成像在识别发热的中性粒细胞减少患者腹痛病因方面的效用。
总结
化疗患者应考虑许多导致发热性中性粒细胞减少的潜在原因。
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