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肾移植受者伴发肿块样脱髓鞘病变:病例报告及文献复习。

Kidney Transplant Recipient With Tumefactive Demyelinating Lesions: A Case Report and Literature Review.

机构信息

Shengli Oilfield Center Hospital, Dongying City, China.

Shengli Oilfield Center Hospital, Dongying City, China.

出版信息

Transplant Proc. 2023 Oct;55(8):1906-1909. doi: 10.1016/j.transproceed.2023.07.006. Epub 2023 Aug 3.

Abstract

Tumefactive demyelinating lesions (TDLs) are rare and specific types of inflammatory demyelinating lesions. Its clinical manifestations are nonspecific, and the imaging findings are similar to those of other intracranial space-occupying lesions, which are usually misdiagnosed as tumors or abscesses and require a pathologic examination to confirm the diagnosis. Tumefactive demyelinating lesions after kidney transplantation are even rarer. This article reports a case of TDLs after kidney transplantation. A 60-year-old female patient underwent kidney transplantation 15 years ago and took anti-rejection drugs such as tacrolimus, tacrolimus, and corticosteroids after surgery. The patient was admitted with headache and left limb weakness, and magnetic resonance imaging of the head showed multiple space-occupying lesions with surrounding edema. The patient underwent a stereotactic biopsy of the encephalopathy lesion, and postoperative pathology confirmed TDLs. She was treated with corticosteroids and discharged after the improvement of her symptoms. Here, to our knowledge, we report the first case of TDLs after kidney transplantation. We report this case to provide clinicians with useful information on intracranial demyelinating disease after kidney transplantation.

摘要

肿块样脱髓鞘病变(TDLs)是一种罕见且具有特异性的炎症性脱髓鞘病变。其临床表现不具特异性,影像学表现类似于其他颅内占位性病变,通常被误诊为肿瘤或脓肿,需要进行病理检查以明确诊断。肾移植后发生肿块样脱髓鞘病变更为罕见。本文报告了 1 例肾移植后 TDLs 病例。1 例 60 岁女性患者 15 年前接受了肾移植,术后服用他克莫司、环孢素和皮质类固醇等抗排异药物。该患者因头痛和左侧肢体无力入院,头部磁共振成像显示多个伴有周围水肿的占位性病变。患者行脑病病变的立体定向活检,术后病理证实为 TDLs。经皮质激素治疗后症状改善后出院。据我们所知,这是首例肾移植后 TDLs 病例。我们报告该病例旨在为临床医生提供肾移植后颅内脱髓鞘疾病的有用信息。

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