Shaheen Najma, Mussai Francis
Birmingham Children's Hospital, Steelhouse Lane, Birmingham, United Kingdom.
J Pediatr Hematol Oncol. 2019 Jan;41(1):e27-e29. doi: 10.1097/MPH.0000000000001077.
A boy with central nervous system relapse of Burkitt leukemia developed fever and neurologic symptoms and cognitive impairment. He had received multi-drug chemotherapy including rituximab. Enterovirus (EV) was detected in cerebrospinal fluid by polymerase chain reaction, and magnetic resonance imaging findings were consistent with viral infection. The patient was treated with intravenous immunoglobulin and within 1 month cleared his EV. Rituximab can cause a profound B-cell deficiency predisposing patients to infections including EV encephalitis. This is the first report of enteroviral encephalitis in a child undergoing treatment for lymphoma with rituximab and suggests the need to watch for this complication of therapy.
一名患有伯基特白血病中枢神经系统复发的男孩出现发热、神经症状和认知障碍。他接受了包括利妥昔单抗在内的多药化疗。通过聚合酶链反应在脑脊液中检测到肠道病毒（EV），磁共振成像结果与病毒感染一致。该患者接受了静脉注射免疫球蛋白治疗，1个月内清除了EV。利妥昔单抗可导致严重的B细胞缺乏，使患者易发生包括EV脑炎在内的感染。这是首例关于接受利妥昔单抗治疗淋巴瘤的儿童发生肠道病毒性脑炎的报告，提示需要警惕这种治疗并发症。
