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[混合性和严重免疫缺陷中的播散性卡介苗感染。尽管尝试进行骨髓移植,但预后不良]

[Generalized BCG infection in mixed and severe immunologic deficiency. Unfavorable outcome in spite of an attempted bone marrow transplant].

作者信息

Genin C, Touraine J L, Berger F, Bryon P A, Valancogne A, Philippe N, Monnet P

出版信息

Arch Fr Pediatr. 1977 Aug-Sep;34(7):639-48.

PMID:337923
Abstract

Generalized BCG infection can occur after vaccination in patients with a severe combined or T-cell immunodeficiency. In the reported case, generalized BCG infection developed in an infant with a severe combined immunodeficiency disease and presented mainly with hematological manifestations. This infection led to death of the patient in spite of an histocompatible bone marrow transplantation performed late in the course of the disease and followed by a minimal graft-versus-host reaction. Based on this case report and others from the literature, it is suggested that neonatal BCG vaccination should be performed after knowing at least the complete family history. Although the presented patient died, it should seem reasonable to treat such patients with an early immunological reconstitution and with anti-TB antibiotics.

摘要

严重联合免疫缺陷或T细胞免疫缺陷患者接种疫苗后可发生播散性卡介苗感染。在报告的病例中,一名患有严重联合免疫缺陷疾病的婴儿发生了播散性卡介苗感染,主要表现为血液学症状。尽管在病程后期进行了组织相容性骨髓移植,且移植后移植物抗宿主反应轻微,但这种感染仍导致了患者死亡。基于本病例报告及文献中的其他病例,建议至少在了解完整家族史后再进行新生儿卡介苗接种。尽管本例患者死亡,但对这类患者进行早期免疫重建并使用抗结核抗生素治疗似乎是合理的。

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