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自身造血干细胞移植后克氏锥虫病再激活。

Reactivation of Chagas disease after autologous hematopoietic stem cell transplantation.

机构信息

Universidad Autónoma de Bucaramanga, Faculty of Health Sciences, Bucaramanga, Santander, Colombia.

Clínica FOSCAL, Hematopoietic and Stem Cell Transplantation Unit, Floridablanca, Santander, Colombia.

出版信息

Rev Soc Bras Med Trop. 2020 Dec 21;54:e20200143. doi: 10.1590/0037-8682-0143-2020. eCollection 2020.

Abstract

Chagas disease (CD) is a protozoan zoonosis caused by Trypanosoma cruzi. Reactivation of CD occurs via drug-induced immunosuppression before and during transplantation. Here, we report the case of a 62-year-old man diagnosed with classic Hodgkin lymphoma who received highly aggressive conditioning chemotherapy before undergoing stem cell transplantation (SCT). The patient tested positive for CD in pre-transplantation evaluation. The patient exhibited persistent fever and elevated C-reactive protein levels before and after SCT, and was treated with antibiotics. Micro-Strout test showed evidence of trypomastigotes and he was treated with benznidazole until tested negative. Post-transplantation seropositive patients should be screened for possible reactivation.

摘要

恰加斯病(CD)是一种由克氏锥虫引起的原生动物人畜共患病。CD 在移植前和移植期间因药物诱导的免疫抑制而重新激活。在这里,我们报告了一例 62 岁男性经典霍奇金淋巴瘤患者,在接受干细胞移植(SCT)前接受了高强度的预处理化疗。该患者在移植前评估中 CD 检测呈阳性。该患者在 SCT 前后持续发热和 C 反应蛋白水平升高,并接受了抗生素治疗。微斯特劳特试验显示有锥虫的存在,他接受了苯并咪唑治疗,直到检测结果转为阴性。移植后血清阳性患者应进行筛查,以确定是否有重新激活的可能。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/39e6/7747816/b7bc8375ec95/1678-9849-rsbmt-54-e20200143-gf1.jpg

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