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慢性移植物抗宿主病相关性多肌炎和心肌炎:病例报告及文献复习。

Chronic graft-versus-host disease-related polymyositis and myocarditis: A case report and review of the literature.

机构信息

Bone Marrow Transplantation Center, The First Affiliated Hospital, School of Medicine, Zhejiang University, , Hangzhou, China; Institute of Hematology, Zhejiang University, Hangzhou, China.

The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.

出版信息

Transpl Immunol. 2022 Jun;72:101598. doi: 10.1016/j.trim.2022.101598. Epub 2022 Apr 2.

Abstract

Chronic graft-versus-host disease (cGVHD) is a major late complication of hematopoietic stem cell transplantation (HSCT). Polymyositis (PM) has been reported to be an uncommon presentation of cGVHD. Myocarditis is an even rarer manifestation of cGVHD-associated PM. Here, we report a 38-year-old male patient developed cGVHD-related PM twelve years post-transplantation, which was confirmed by muscle biopsy and immunological study. The presence of pain in the chest area, dynamic changes in the electrocardiogram, as well as elevated troponin and myocardial enzyme levels with improvement after immunotherapy all pointed to cardiac involvement. Ruxolitinib in combination with tachlimus and methylprednisolone successfully treated cGVHD associated PM with myocarditis. The literature on cGVHD-related PM and myocarditis is briefly reviewed.

摘要

慢性移植物抗宿主病(cGVHD)是造血干细胞移植(HSCT)的一种主要迟发性并发症。多发性肌炎(PM)已被报道为 cGVHD 的一种不常见表现。心肌炎是 cGVHD 相关 PM 的一种更为罕见的表现。在此,我们报告了一例 38 岁男性患者在移植后 12 年发生 cGVHD 相关 PM,该病例通过肌肉活检和免疫学研究得到确诊。胸痛、心电图动态变化以及肌钙蛋白和心肌酶水平升高,经免疫治疗后改善,这些都提示存在心脏受累。鲁索利替尼联合他克莫司和甲泼尼龙成功治疗了伴有心肌炎的 cGVHD 相关 PM。本文简要回顾了与 cGVHD 相关 PM 和心肌炎的文献。

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