Pillans P, Novitsky N, Jacobs P
S Afr Med J. 1983 Jul 16;64(3):84-9.
Jaundice presented a major diagnostic and therapeutic problem in 6 out of 20 patients undergoing allogeneic bone marrow transplantation for severe acute aplastic anaemia or leukaemia in relapse. In the first 2 cases histological features of graft-versus-host disease were demonstrable in the skin but absent in the liver. In the 3rd case B-virus hepatitis was the most likely diagnosis, in the 4th cumulative cytotoxic chemotherapy was incriminated, and in the last 2 cases the jaundice was obstructive. These 6 cases illustrate the varied causation of jaundice in patients undergoing bone marrow transplantation, and emphasize that correct diagnosis is essential for rational management.
在20例因严重急性再生障碍性贫血或白血病复发而接受异基因骨髓移植的患者中，有6例出现黄疸，这构成了一个主要的诊断和治疗难题。在前2例中，移植物抗宿主病的组织学特征在皮肤中可得到证实，但在肝脏中未出现。在第3例中，B病毒肝炎是最可能的诊断；在第4例中，累积的细胞毒性化疗被认为是病因；在最后2例中，黄疸是梗阻性的。这6例病例说明了骨髓移植患者黄疸的多种病因，并强调正确的诊断对于合理治疗至关重要。
