Department of Paediatrics, Monash Children's Hospital, Clayton, Victoria, Australia
Department of Paediatrics, Monash Children's Hospital, Clayton, Victoria, Australia.
BMJ Case Rep. 2021 Nov 30;14(11):e245592. doi: 10.1136/bcr-2021-245592.
A 14-year-old boy with 22q11.2 deletion syndrome and a right ventricular to pulmonary artery xenograft conduit presented to an Australian tertiary children's hospital with prolonged fevers, weight loss, splenomegaly and a high proportion of gamma-delta T cells in peripheral blood and bone marrow, concerning for possible gamma-delta T-cell lymphoma. However, investigations did not reveal evidence of lymphoma or autoimmune disease. After 5 months of intermittent fever episodes and ongoing symptoms, he was found to have an extremely high titre (8192) on serological testing, with the organism also detected on blood PCR. After 6 months of oral azithromycin and rifampicin, with complete resolution of his symptoms 3 months into treatment, his blood PCR was negative and gamma-delta T cells in peripheral blood were decreasing. The titre remained unchanged for some time, but decreased to 2048 around 1 year after treatment was started.
一名 14 岁男孩患有 22q11.2 缺失综合征和右心室至肺动脉异种移植物通道，因持续发热、体重减轻、脾肿大以及外周血和骨髓中大量γ-δ T 细胞而到澳大利亚一家三级儿童医院就诊，考虑可能患有 γ-δ T 细胞淋巴瘤。然而，检查并未发现淋巴瘤或自身免疫性疾病的证据。在经历了 5 个月的间歇性发热发作和持续症状后，他的血清学检测结果显示极高滴度（8192），血液 PCR 也检测到该病原体。在接受 6 个月的口服阿奇霉素和利福平治疗后，治疗 3 个月后症状完全缓解，他的血液 PCR 转为阴性，外周血中的γ-δ T 细胞也在减少。滴度在一段时间内保持不变，但在开始治疗 1 年后降至 2048。
