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一名急性淋巴细胞白血病患者发生移植物抗宿主病后的抑郁:病例报告。

Depression following graft-versus-host disease in a patient with acute lymphoblastic leukaemia: A case report.

作者信息

Tsamakis Konstantinos, Mueller Christoph, Tsirigotis Panagiotis, Tsiptsios Dimitrios, Tsamakis Charalampos, Charakopoulos Emmanouil, Charalampous Chistophis, Spandidos Demetrios A, Douzenis Athanasios, Papageorgiou Charalabos, Liappas Ioannis, Rizos Emmanouil

机构信息

Second Department of Psychiatry, School of Medicine, University General Hospital 'Attikon', 12462 Athens, Greece.

King's College London, Institute of Psychiatry, Psychology and Neuroscience, London SE5 8AF, London, UK.

出版信息

Mol Clin Oncol. 2020 Mar;12(3):208-211. doi: 10.3892/mco.2019.1970. Epub 2019 Dec 19.

Abstract

There is increasing evidence to suggest an association between depression and inflammation, with patients suffering from immune mediated-disorders exhibiting higher levels of depression. Inflammation in depression is a potential target for the development of novel treatment strategies. The present study presents a clinical case in which a patient with an underlying inflammatory condition acutely developed a severe depressive episode resulting in a sudden, dramatic change in their clinical picture. This case, with no similar case reports being in the literature thus far, at least to the best of our knowledge, highlights the increasing consideration that there may be a causative role between neuro-inflammation and depression. This study reports the case of a 40-year-old male with acute lymphoblastic leukaemia (ALL) and no previous psychiatric history, who developed an acute onset of a severe depressive episode in the context of the immune-mediated graft-versus-host disease (GVHD). GVHD is a complication of allogeneic hematopoietic cell transplantation, which the patient had undergone, for the treatment of his ALL. The rapid onset of depression could be explained by the neuroinflammatory processes occurring in GVHD. This provides a clinical example for the possible role of the immune system in depression, and clinicians should be aware of this association.

摘要

越来越多的证据表明抑郁症与炎症之间存在关联,患有免疫介导疾病的患者抑郁症水平更高。抑郁症中的炎症是新型治疗策略开发的潜在靶点。本研究呈现了一个临床病例,一名患有潜在炎症性疾病的患者急性发作严重抑郁发作,导致其临床症状突然发生显著变化。据我们所知,目前文献中尚无类似病例报告,该病例凸显了越来越多人认为神经炎症与抑郁症之间可能存在因果关系。本研究报告了一名40岁男性病例,该男性患有急性淋巴细胞白血病(ALL)且既往无精神病史,在免疫介导的移植物抗宿主病(GVHD)背景下急性发作严重抑郁发作。GVHD是该患者接受异基因造血细胞移植治疗ALL后的一种并发症。抑郁症的快速发作可以用GVHD中发生的神经炎症过程来解释。这为免疫系统在抑郁症中可能发挥的作用提供了一个临床实例,临床医生应意识到这种关联。

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Cutaneous Graft-Versus-Host Disease: Diagnosis and Treatment.皮肤移植物抗宿主病:诊断与治疗。
Am J Clin Dermatol. 2018 Feb;19(1):33-50. doi: 10.1007/s40257-017-0306-9.
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Clinical updates in adult acute lymphoblastic leukemia.成人急性淋巴细胞白血病的临床进展
Crit Rev Oncol Hematol. 2016 Mar;99:189-99. doi: 10.1016/j.critrevonc.2015.12.007. Epub 2015 Dec 19.

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