苯丁酸氮芥治疗的慢性淋巴细胞白血病背景下的进行性多灶性白质脑病：尼泊尔的一例病例报告
Progressive multifocal leukoencephalopathy in the background of chlorambucil treated chronic lymphocytic leukemia: a case report from Nepal.
作者信息
Dhakal Bishal, Upadhaya Regmi Binit, Subedi Ram Chandra, Joshi Sushil, Pathak Bishnu Deep, Bogati Kanchan, Baniya Sunil, Neupane Peter, Paudel Raju
机构信息
Nepalese Army Institute of Health and Sciences, College of Medicine.
Jibjibe Primary Health Care Center, Rasuwa, Nepal.
出版信息
Ann Med Surg (Lond). 2023 Aug 14;85(10):5167-5170. doi: 10.1097/MS9.0000000000001190. eCollection 2023 Oct.
INTRODUCTION
Progressive multifocal leukoencephalopathy is a rare manifestation in itself. Although many immunosuppressive states are associated with the disease, its occurrence in the setting of chronic lymphocytic leukaemia treated with chemotherapy is seldom reported to date.
CASE PRESENTATION
A 67-year-old woman with known chronic lymphocytic leukaemia who was previously receiving chlorambucil treatment was identified as having progressive multifocal leukoencephalopathy; her prognosis is currently good.
CLINICAL DISCUSSION
Although a rare disease in an immunocompromised setting, progressive multifocal leukoencephalopathy often leads to a grave outcome. However, the authors describe a case with a good prognosis to date.
CONCLUSION
Progressive multifocal leukoencephalopathy should be in differentials in immunocompromised patients with dementia. Given that the later prognosis of the disease is unpredictable, an earlier diagnosis would be better for immunological reconstitution.
引言
进行性多灶性白质脑病本身是一种罕见的表现。尽管许多免疫抑制状态与该疾病相关，但迄今为止，其在接受化疗的慢性淋巴细胞白血病患者中发生的情况鲜有报道。
病例介绍
一名67岁的已知慢性淋巴细胞白血病女性患者，之前接受苯丁酸氮芥治疗，被确诊为进行性多灶性白质脑病；她目前的预后良好。
临床讨论
尽管进行性多灶性白质脑病在免疫功能低下的情况下是一种罕见疾病，但通常会导致严重后果。然而，作者描述了一例迄今为止预后良好的病例。
结论
进行性多灶性白质脑病应列入免疫功能低下的痴呆患者的鉴别诊断中。鉴于该疾病后期的预后不可预测，早期诊断对免疫重建更有利。
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