Rogers S Y, Irving W, Harris A, Russell N H
University Department of Haematology, City Hospital, Nottingham, UK.
Bone Marrow Transplant. 1995 May;15(5):805-7.
A 41-year-old patient with acute myeloid leukemia was transplanted from an HLA-identical but ABO-incompatible sibling. The post-transplant course was complicated by pure erythrocyte aplasia and mild chronic graft-versus-host disease. Eleven months after transplant while on steroid therapy she developed abdominal pain rapidly followed by fatal fulminant hepatic failure. Varicella zoster virus (VZV) was detected using the polymerase chain reaction from blood and liver obtained at necropsy even though no skin manifestations of VZV were present. This case confirms previous reports of visceral VZV infection in the absence of skin lesions thus emphasising the importance of suspecting the presence of VZV in this clinical setting and outlines the possible value of PCR in the rapid diagnosis of infection.
一名41岁的急性髓系白血病患者接受了来自HLA相同但ABO血型不相合的同胞的移植。移植后的病程因纯红细胞再生障碍和轻度慢性移植物抗宿主病而复杂化。移植11个月后，她在接受类固醇治疗时迅速出现腹痛，随后发展为致命的暴发性肝衰竭。尽管尸检时未发现水痘带状疱疹病毒（VZV）的皮肤表现，但通过聚合酶链反应从血液和肝脏中检测到了VZV。该病例证实了先前关于无皮肤病变时内脏VZV感染的报道，从而强调了在这种临床情况下怀疑VZV存在的重要性，并概述了PCR在感染快速诊断中的可能价值。
