Hospital de Clinicas "José de San Martín", Universidad de Buenos Aires.
Rev Fac Cien Med Univ Nac Cordoba. 2022 Sep 16;79(3):304-306. doi: 10.31053/1853.0605.v79.n3.34402.
An 18-year-old male was admitted for his second induction chemotherapy treatment for an acute lymphoblastic leukaemia with cyclophosphamide, cytarabine, and mercaptopurine. He presented with high fever, abdominal pain, non-bloody diarrhoea, portal hypertension and leukopenia. Stool sample analysis, blood cultures and extensive work-up were negative. The only microbiologic evidence was the presence of cytomegalovirus DNA detected by PCR. A profound hypogammaglobulinemia was documented. Pathology material reported non-caseating granulomas in liver, bone marrow, duodenum and colon with negative cytomegalovirus immunostaining. What is your diagnosis?
一位 18 岁男性因急性淋巴细胞白血病接受环磷酰胺、阿糖胞苷和巯嘌呤的第二次诱导化疗而入院。他出现高热、腹痛、无血腹泻、门静脉高压和白细胞减少。粪便样本分析、血培养和广泛的检查均为阴性。唯一的微生物学证据是聚合酶链反应检测到巨细胞病毒 DNA 的存在。明确存在低丙种球蛋白血症。病理材料报告肝脏、骨髓、十二指肠和结肠存在非干酪性肉芽肿，巨细胞病毒免疫染色阴性。你的诊断是什么？
