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病例报告:免疫功能正常的成年人中急性巨细胞病毒感染相关的急性门静脉血栓形成

Case report: acute portal vein thrombosis associated with acute cytomegalovirus infection in an immunocompetent adult.

作者信息

Puccia Fania, Lombardo Vania, Giannitrapani Lydia, Licata Anna, Mazzola Giovanni, Soresi Maurizio

机构信息

Biomedical Department of Internal Medicine and Specialities, University of Palermo, Via del Vespro 141, 90127 Palermo, Italy.

Department of Sciences for Health Promotion and Mother-Child Care "G. D'Alessandro", University of Palermo, Via del Vespro 127, 90127 Palermo, Italy.

出版信息

J Ultrasound. 2017 Feb 27;20(2):161-165. doi: 10.1007/s40477-016-0227-0. eCollection 2017 Jun.

Abstract

Cytomegalovirus (CMV) infection is usually asymptomatic and self-limiting in healthy individuals, but significant complications can develop in immunosuppressed patients. Venous or arterial thromboembolic phenomena are uncommon yet very serious complications of CMV infection. Most published reports describe immunosuppressed patients, but thrombotic events in CMV-infected immunocompetent individuals may also occur. We describe the case of an immunocompetent young man with acute CMV hepatitis that was complicated with portal vein thrombosis (PVT). We also review the literature regarding the association between PVT and CMV in immunocompetent patients. Thromboembolism is an underestimated but significant complication of acute CMV infection. Several local and systemic factors are involved in the pathogenesis of acute PVT. This case emphasizes the central role of ultrasound in its diagnosis and the potentially serious complications that can occur in immunocompetent individuals with no other prothrombotic risk factors.

摘要

巨细胞病毒(CMV)感染在健康个体中通常无症状且为自限性,但在免疫抑制患者中可能会出现严重并发症。静脉或动脉血栓栓塞现象是CMV感染罕见但非常严重的并发症。大多数已发表的报告描述的是免疫抑制患者,但CMV感染的免疫功能正常个体也可能发生血栓形成事件。我们报告一例免疫功能正常的年轻男性急性CMV肝炎并发门静脉血栓形成(PVT)的病例。我们还回顾了免疫功能正常患者中PVT与CMV之间关联的相关文献。血栓栓塞是急性CMV感染一种被低估但很重要的并发症。急性PVT的发病机制涉及多种局部和全身因素。该病例强调了超声在其诊断中的核心作用以及在无其他血栓形成危险因素的免疫功能正常个体中可能发生的潜在严重并发症。

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