Clinic I of Internal Medicine, University Hospital of Cologne, Cologne, Germany.
Institute of Pathology, University Hospital of Cologne, Cologne, Germany.
Eur J Haematol. 2018 Apr;100(4):383-385. doi: 10.1111/ejh.12998. Epub 2017 Dec 17.
Cryptosporidium infection is a rare cause of enterocolitis. In immunocompromised patients, cryptosporidiosis may lead to debilitating and life-threatening diarrhea and malabsorption, occasionally with multi-organ involvement. Allogeneic hematopoietic stem cell transplantation (allo-HSCT) requires long-term immunosuppressive therapy, while cellular immunity is usually compromised due to intensive conditioning chemotherapy. Diarrhea in patients who underwent allo-HSCT may be a sign of an infection, but can also be the result of intestinal graft-versus-host disease (GvHD). Here, we describe the case of a patient who developed severe diarrhea following allo-HSCT for relapsed T-lymphoblastic lymphoma. Initially, GvHD was suspected and treatment was initiated accordingly. However, a colon biopsy showed signs of cryptosporide oocysts alongside only low-grade GvHD. Following molecular confirmation of the diagnosis of cryptosporidiosis, an intensive treatment regimen was started. Despite the severe clinical course, the patient recovered and was discharged with only residual symptoms.
隐孢子虫感染是肠炎的一种罕见病因。在免疫功能低下的患者中，隐孢子虫病可能导致使人虚弱和危及生命的腹泻和吸收不良，偶尔还会涉及多个器官。异基因造血干细胞移植（allo-HSCT）需要长期免疫抑制治疗，而细胞免疫通常因强化预处理化疗而受损。allo-HSCT 后的患者腹泻可能是感染的迹象，但也可能是肠移植物抗宿主病（GvHD）的结果。在这里，我们描述了一例复发 T 淋巴细胞性淋巴瘤患者接受 allo-HSCT 后出现严重腹泻的病例。最初怀疑发生 GvHD，并据此开始治疗。然而，结肠活检显示有隐孢子虫卵囊，而仅有低度 GvHD。在分子确认隐孢子虫病的诊断后，开始了强化治疗方案。尽管临床病程严重，但患者仍恢复并仅遗留残留症状出院。
