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中性粒细胞减少性不明原因发热和播散性肉芽肿病在急性淋巴细胞白血病患者中的表现。

Neutropenic fever of unknown origin and disseminated granulomatous disease in a patient with acute lymphoblastic leukemia.

机构信息

Hospital de Clinicas "José de San Martín", Universidad de Buenos Aires.

出版信息

Rev Fac Cien Med Univ Nac Cordoba. 2022 Sep 16;79(3):304-306. doi: 10.31053/1853.0605.v79.n3.34402.

Abstract

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?

摘要

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?

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/63a6/9590815/318160af4660/1853-0605-79-3-304-g001.jpg

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