Youssef Michael, Stratton Tyler W, Gallant Reid C, Young Christine, Li Daniel Y, Piran Siavash
Faculty of Medicine, University of Toronto, Toronto, Canada.
Schulich School of Medicine & Dentistry, Western University, London, ON, Canada.
Case Rep Hematol. 2022 Mar 22;2022:8271069. doi: 10.1155/2022/8271069. eCollection 2022.
We report a case of pure white cell aplasia (PWCA) postthymoma resection in a 74-year-old male presenting with a 2-week history of fevers, night sweats, and severe febrile neutropenia. His pure white cell aplasia was treated with intravenous immunoglobulin (IVIg), granulocyte colony-stimulating factor (G-CSF), prednisone, and cyclosporine with a mixed response. He also developed immune thrombocytopenia, which responded well to a short course of eltrombopag. With continued cyclosporine treatment, his platelet counts were stable after stopping eltrombopag. The patient's cyclosporine treatment was complicated by renal failure, resulting in cessation of cyclosporine. His PWCA and immune thrombocytopenia significantly worsened after stopping cyclosporine, and unfortunately, he died from multiorgan failure and sepsis.
我们报告一例74岁男性胸腺瘤切除术后发生纯白细胞再生障碍(PWCA)的病例,该患者有两周的发热、盗汗及严重发热性中性粒细胞减少病史。其纯白细胞再生障碍采用静脉注射免疫球蛋白(IVIg)、粒细胞集落刺激因子(G-CSF)、泼尼松和环孢素治疗,反应不一。他还出现了免疫性血小板减少症,对短期使用艾曲泊帕反应良好。持续使用环孢素治疗后,停用艾曲泊帕后其血小板计数稳定。该患者的环孢素治疗因肾衰竭而复杂化,导致环孢素停用。停用环孢素后,他的PWCA和免疫性血小板减少症显著恶化,不幸的是,他死于多器官功能衰竭和败血症。