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一名患有暴发性肝炎并伴有急性转氨酶升高、多发性骨髓瘤和甲状腺癌的乙肝携带者

[A HBV carrier with fulminant hepatitis complicated by ATL, multiple myeloma and thyroid cancer].

作者信息

Shimano S, Murayama K, Ogawa A, Katahira H, Tsuchiya J, Akimoto Y, Lee M

机构信息

Department of Internal Medicine, Gunma Cancer Center.

出版信息

Rinsho Ketsueki. 1995 Aug;36(8):774-9.

PMID:7563612
Abstract

A 75-year-old female, born in Tochigi Prefecture, was admitted because of lumbago in August of 1991. The leukocyte count was 11,800/microliters with 22.5% atypical lymphocytes. We demonstrated a lymphocyte surface marker, ATL-associated antigen, and proviral DNA. We also identified 2.60 g/dl of serum monoclonal protein, found to be IgG, lambda type, and punched out lesions in the skull. We made a diagnosis of ATL. She was also a HBV carrier. The patient was treated with a modification of CHOP therapy, because of increasing atypical lymphocytes in the peripheral blood in November of 1992. She died of acute hepatitis, suddenly, in March of 1993. Autopsy revealed multiple myeloma, fulminant hepatitis and occult thyroid cancer in addition to ATL.

摘要

一名75岁女性,出生于枥木县,因腰痛于1991年8月入院。白细胞计数为11,800/微升,其中非典型淋巴细胞占22.5%。我们检测到一种淋巴细胞表面标志物、成人T细胞白血病相关抗原和前病毒DNA。我们还发现血清单克隆蛋白为2.60 g/dl,为IgG、λ型,颅骨有穿凿样病变。我们诊断为成人T细胞白血病。她也是一名乙肝携带者。1992年11月,由于外周血中非典型淋巴细胞增多,患者接受了改良的CHOP疗法治疗。1993年3月,她突然死于急性肝炎。尸检显示除成人T细胞白血病外,还有多发性骨髓瘤、暴发性肝炎和隐匿性甲状腺癌。

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