Apperley J F, Rice S J, Hewitt P, Rombos Y, Barbara J, Gabriel F G, Goldman J M
Royal Postgraduate Medical School, London, U.K.
Eur J Haematol. 1987 Aug;39(2):185-9. doi: 10.1111/j.1600-0609.1987.tb00752.x.
A 30-yr-old man with chronic granulocytic leukaemia received a bone marrow transplant from his histocompatible sister in December 1982. His post-transplant course was complicated by Grade III graft-versus-host disease and multiple infectious episodes until his death from pneumonia on d + 190. He was later found to be seropositive for anti-HIV at the time of his death. Retrospective analysis of stored sera showed a transient period of seropositivity from d + 11 to d + 20 thought to reflect passive transfer of antibody from a blood product transfused prior to d + 11 when he was also exposed to infectious virus. He remained seronegative until d + 78 when anti-HIV was again found. Seropositivity persisted until his death and was attributed to endogenous antibody response. Although it is unclear whether his clinical course was due to AIDS, exposure of an immunosuppressed patient to HIV may be associated with more rapid development of clinical disease.
一名30岁的慢性粒细胞白血病男性患者于1982年12月接受了来自其组织相容性匹配的姐姐的骨髓移植。移植后的病程出现了III级移植物抗宿主病和多次感染发作,直至他在移植后第190天死于肺炎。后来发现他在死亡时抗HIV血清学呈阳性。对储存血清的回顾性分析显示,在移植后第11天至第20天有一段短暂的血清学阳性期,据认为这反映了在移植后第11天之前输入的血液制品中抗体的被动转移,当时他也接触了感染性病毒。他一直保持血清学阴性,直到移植后第78天再次检测到抗HIV。血清学阳性一直持续到他死亡,被归因于内源性抗体反应。虽然尚不清楚他的临床病程是否由艾滋病引起,但免疫抑制患者接触HIV可能与临床疾病的更快发展有关。