Amoateng Richard, Hardman Brent, Liu Catherine, Austin Scarlett
Internal Medicine, Allegheny Health Network, Pittsburgh, Pennsylvania, USA
Internal Medicine, Allegheny Health Network, Pittsburgh, Pennsylvania, USA.
BMJ Case Rep. 2021 Mar 22;14(3):e241799. doi: 10.1136/bcr-2021-241799.
A 61-year-old man was transferred to our facility from an outside hospital due to refractory neutropaenia of unknown aetiology. The patient presented to the referring hospital with a 5-day history of worsening diarrhoea and abdominal pain. Initial lab results at presentation showed severe neutropaenia with an absolute neutrophil count of 0. Investigations included a bone marrow biopsy which showed slightly hypocellular marrow with near absence of granulocytic precursors. A CT without contrast showed evidence of chronic pancreatitis and acute colitis. The patient's neutropaenia persisted despite granulocyte colony-stimulating factor therapy. The patient was, thus, transferred to our facility for a higher level of care. At our facility, the patient had rapid correction of neutropaenia after discontinuation of pancrelipase therapy. The patient's abdominal pain and diarrhoea also improved while off pancrelipase. Neutropaenia has completely resolved 6 weeks after discharge without any further therapy.
一名61岁男性因病因不明的难治性中性粒细胞减少症从外院转入我院。患者因腹泻和腹痛加重5天就诊于转诊医院。初诊时实验室检查结果显示严重中性粒细胞减少，绝对中性粒细胞计数为0。检查包括骨髓活检，结果显示骨髓细胞轻度减少，几乎没有粒细胞前体。非增强CT显示有慢性胰腺炎和急性结肠炎的迹象。尽管使用了粒细胞集落刺激因子治疗，患者的中性粒细胞减少症仍持续存在。因此，患者被转入我院接受更高水平的治疗。在我院，患者停用胰酶治疗后中性粒细胞减少症迅速得到纠正。停用胰酶后，患者的腹痛和腹泻也有所改善。出院6周后，中性粒细胞减少症完全缓解，无需进一步治疗。
