Nasser Keaton, Joshi Kshipra, Starobinska Ella
Internal Medicine, Banner University Medical Center, Tucson, Arizona, USA.
BMJ Case Rep. 2018 Dec 14;11(1):e227507. doi: 10.1136/bcr-2018-227507.
A 24-year-old man with previous matched unrelated donor allogenic bone marrow transplant for aplastic anaemia and chronic graft versus host disease on steroid taper presented with progressively worsening anasarca. CT revealed large pericardial effusion, while echocardiogram was concerning for early tamponade physiology. He underwent emergent pericardiocentesis with pericardial drain placement. Extensive rheumatological and infectious work-up was unrevealing with patient's presentation attributed to pericardial graft versus host disease. This highlights the need of physicians to be aware of pericardial serositis as a complication of graft versus host disease due to its life-threatening complications, which require immediate intervention.
一名24岁男性，既往因再生障碍性贫血接受了匹配的无关供者异基因骨髓移植，目前慢性移植物抗宿主病正在逐渐减少类固醇用量，现出现进行性加重的全身性水肿。CT显示大量心包积液，而超声心动图提示早期心包填塞生理状态。他接受了紧急心包穿刺并放置心包引流管。广泛的风湿免疫和感染方面的检查均未发现异常，患者的表现归因于心包移植物抗宿主病。这凸显了医生需要意识到心包浆膜炎作为移植物抗宿主病的一种并发症，因其具有危及生命的并发症，需要立即干预。
