心脏移植后巨细胞病毒性心肌炎并发排斥反应1例罕见病例报告及文献复习
A rare case of cytomegalovirus myocarditis complicating rejection after heart transplantation: Case report and review of literature.
作者信息
Abete Raffaele, Iacovoni Attilio, Vittori Claudia, Sebastiani Roberta, Candiago Elisabetta, Gianatti Andrea, Terzi Amedeo, Senni Michele
机构信息
Department of Transplant Surgery and Surgical Treatment of Heart Failure, Azienda Socio Sanitaria Territoriale Papa Giovanni XXIII, Bergamo, Italy.
Department of Pathology, Azienda Socio Sanitaria Territoriale Papa Giovanni XXIII, Bergamo, Italy.
出版信息
J Cardiol Cases. 2025 Jan 16;31(4):105-108. doi: 10.1016/j.jccase.2024.12.007. eCollection 2025 Apr.
UNLABELLED
A 49-year-old female with terminal hypertrophic cardiomyopathy underwent orthotopic heart transplantation. The patient developed early acute rejection. Intensifying therapy led to improvement, but cytomegalovirus (CMV) myocarditis emerged. Aggressive management, including high-dose ganciclovir and intravenous immunoglobulin, resulted in negativization of CMV and rejection markers. Cardiac function recovered, emphasizing the challenges and successful multidisciplinary approach in managing complex post-transplant complications.
LEARNING OBJECTIVES
To diagnose and treat complications in heart transplantation, such as opportunistic infections and cellular and/or antibody-mediated rejection. To underline role of endomyocardial biopsy in heart transplant monitoring.
未标注
一名49岁终末期肥厚型心肌病女性接受了原位心脏移植。患者发生了早期急性排斥反应。强化治疗使其病情得到改善，但随后出现了巨细胞病毒（CMV）心肌炎。积极的治疗措施，包括大剂量更昔洛韦和静脉注射免疫球蛋白，使CMV和排斥反应标志物转阴。心脏功能得以恢复，这凸显了在处理复杂的移植后并发症时所面临的挑战以及成功的多学科方法。
学习目标
诊断和治疗心脏移植中的并发症，如机会性感染以及细胞和/或抗体介导的排斥反应。强调心内膜心肌活检在心脏移植监测中的作用。
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