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化疗期间血液系统疾病患者的人细小病毒B19感染

[Human parvovirus B19 infection in patients with hematologic disorders on chemotherapy].

作者信息

Fujita H, Takada K, Kuremoto K, Ishimoto K, Sato N, Tsuji A, Yoshida H, Kaneko M, Hirai H, Yamaguchi T

机构信息

Department of Pediatrics, Juntendo University School of Medicine.

出版信息

Rinsho Ketsueki. 1993 Jan;34(1):28-33.

PMID:8450604
Abstract

We described two cases having erythroid hypoplasia and pancytopenia, respectively, caused by human parvovirus B19 (PVB19) infection on chemotherapy. The first patient was a seven-year-old boy with Non-Hodgkin's lymphoma. He has obtained complete remission with LSA2L2 protocol, but, immediately after this remission, he suddenly developed high fever, erythema on cheeks and severe anemia without reticulocytes. We concluded that the cause of anemia and other symptoms were due to PVB19 infection because PVB19 DNA in his serum was detected by dot blot hybridization and polymerase chain reaction, although specific antibodies to PVB19 remained absent. He received gamma-globulin intravenously (200mg/kg/day for 5 days). The fever and erythema were improved promptly, but viremia and anemia lasted a few weeks and the specific antibodies to PVB19 were negative for about two months thereafter. The second patient was a nine-year-old boy with common ALL in remission. Pancytopenia suddenly occurred under maintenance therapy. Because IgM to PVB19 was detected in his serum, the patient was diagnosed to have temporary pancytopenia due to PVB19 infection. In conclusion, it is important to confirm specific antibodies and PVB19 DNA in serum when anemia or pancytopenia of unknown cause occurs in immunocompromised patients receiving chemotherapy.

摘要

我们描述了两例分别因化疗期间感染人细小病毒B19(PVB19)而导致红系造血低下和全血细胞减少的病例。首例患者是一名七岁的非霍奇金淋巴瘤男孩。他采用LSA2L2方案已获得完全缓解,但在缓解后不久,突然出现高热、面颊红斑和严重贫血且无网织红细胞。我们得出结论,贫血及其他症状的病因是PVB19感染,因为通过斑点杂交和聚合酶链反应在其血清中检测到了PVB19 DNA,尽管当时仍未检测到针对PVB19的特异性抗体。他接受了静脉注射丙种球蛋白(200mg/kg/天,共5天)治疗。发热和红斑迅速改善,但病毒血症和贫血持续了几周,此后针对PVB19的特异性抗体在约两个月内呈阴性。第二例患者是一名九岁的处于缓解期的普通急性淋巴细胞白血病男孩。在维持治疗期间突然发生全血细胞减少。由于在其血清中检测到了针对PVB19的IgM,该患者被诊断为因PVB19感染导致的暂时性全血细胞减少。总之,当接受化疗的免疫功能低下患者出现不明原因的贫血或全血细胞减少时,确认血清中的特异性抗体和PVB19 DNA非常重要。

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