Hosokawa Yuka, Toubai Tomomi, Ohe Rintaro, Hosokawa Masashi, Sato Ryo, Yamada Akane, Aizawa Keiko, Himuro Masahito, Ito Satoshi, Yamamoto Masakazu, Peltier Daniel, Ishizawa Kenichi
Department of Internal Medicine III, Division of Hematology and Cell Therapy, Yamagata University Faculty of Medicine, Yamagata, Japan.
Department of Pathology, Yamagata University Faculty of Medicine, Yamagata, Japan.
Blood Cell Ther. 2022 Jun 3;5(3):79-82. doi: 10.31547/bct-2021-023. eCollection 2022 Aug 25.
We report the case of a 28-year-old woman who developed upper abdominal pain and jaundice after a second unrelated allogeneic hematopoietic cell transplantation (allo-HCT) for acute lymphoid leukemia (ALL). Laboratory data showed elevated levels of liver enzymes, amylase, and lipase. Although acute pancreatitis was suspected, no structural lesions were detected. Liver biopsy was compatible with late-onset acute graft-versus-host disease (GVHD), which resolved following treatment with methylprednisolone (mPSL) and tacrolimus (TAC). In addition, her serum amylase level and abdominal pain rapidly resolved following acute GVHD-directed therapy. Acute pancreatitis concomitant with late-onset acute liver GVHD is extremely rare and has not been documented subsequent to a second allo-HCT.
我们报告了一例28岁女性患者，她在因急性淋巴细胞白血病（ALL）进行第二次非相关异基因造血细胞移植（allo-HCT）后出现上腹部疼痛和黄疸。实验室数据显示肝酶、淀粉酶和脂肪酶水平升高。尽管怀疑是急性胰腺炎，但未检测到结构病变。肝活检结果符合迟发性急性移植物抗宿主病（GVHD），经甲泼尼龙（mPSL）和他克莫司（TAC）治疗后病情缓解。此外，在针对急性GVHD的治疗后，她的血清淀粉酶水平和腹痛迅速缓解。迟发性急性肝GVHD合并急性胰腺炎极为罕见，在第二次allo-HCT后尚未见相关报道。
