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用于内脏利什曼病患者诊断和疗效评估的下一代测序技术:一例病例报告。

Next-generation sequencing technology for diagnosis and efficacy evaluation of a patient with visceral leishmaniasis: A case report.

作者信息

Lin Zhou-Ning, Sun Yong-Cheng, Wang Jia-Ping, Lai Yan-Li, Sheng Li-Xia

机构信息

Internal Medicine, School of Medicine Ningbo University, Ningbo 315000, Zhejiang Province, China.

Department of Hematology, Ningbo First Hospital, Ningbo 315000, Zhejiang Province, China.

出版信息

World J Clin Cases. 2021 Nov 16;9(32):9903-9910. doi: 10.12998/wjcc.v9.i32.9903.

Abstract

BACKGROUND

Visceral leishmaniasis (VL) is a parasitic disease caused by and transmitted by infected sand flies. VL has a low incidence in China, and its clinical presentation is complex and atypical. This disease is easily misdiagnosed and can become life-threatening within a short period of time. Therefore, early, rapid and accurate diagnosis and treatment of the disease are essential.

CASE SUMMARY

A 25-year-old male patient presented with the clinical manifestations of irregular fever, hepatosplenomegaly, increased polyclonal globulin, and pancytopenia. The first bone marrow puncture biopsy did not provide a clear diagnosis. In order to relieve the pressure and discomfort of the organs caused by the enlarged spleen and to confirm the diagnosis, splenectomy was performed, and hemophagocytic syndrome was diagnosed by pathological examination of the spleen biopsy. Following bone marrow and spleen pathological re-diagnosis and metagenomic next-generation sequencing (mNGS) technology detection, the patient was finally diagnosed with VL. After treatment with liposomal amphotericin B, the body temperature quickly returned to normal and the hemocytes recovered gradually. Post-treatment re-examination of the bone marrow puncture and mNGS data showed that was not detected.

CONCLUSION

As a fast and accurate detection method, mNGS can diagnose and evaluate the efficacy of treatment in suspicious cases of leishmaniasis.

摘要

背景

内脏利什曼病(VL)是一种由感染的白蛉传播的寄生虫病。VL在中国发病率较低,其临床表现复杂且不典型。该病易被误诊,且可在短时间内危及生命。因此,对该病进行早期、快速、准确的诊断和治疗至关重要。

病例摘要

一名25岁男性患者出现不规则发热、肝脾肿大、多克隆球蛋白升高和全血细胞减少的临床表现。首次骨髓穿刺活检未明确诊断。为缓解脾脏肿大引起的器官压力和不适并确诊,进行了脾切除术,脾脏活检病理检查诊断为噬血细胞综合征。经过骨髓和脾脏病理重新诊断以及宏基因组下一代测序(mNGS)技术检测,患者最终被诊断为VL。用脂质体两性霉素B治疗后,体温迅速恢复正常,血细胞逐渐恢复。治疗后骨髓穿刺复查和mNGS数据显示未检测到(此处原文缺失内容)。

结论

作为一种快速准确的检测方法,mNGS可对利什曼病可疑病例进行诊断并评估治疗效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cf06/8610921/da5d71ad1675/WJCC-9-9903-g001.jpg

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