Pulik M, Teillet F, Teillet-Thiebaud F, Lionnet F, Genet P, Petitdidier C
Service d'Hématologie, Hôpital Victor-Dupouy, Argenteuil
Ann Med Interne (Paris). 1995;146(5):292-4.
We report four cases of varicella-zoster pancreatitis in immunocompromised hosts. All 4 patients presented a severe immunodeficiency because of chronic lymphoproliferative disorders (mainly lymphoma and Hodgkin disease) and long-term immunosuppressive therapy. Varicella zoster pancreatitis is a very unusual presentation of varicella-zoster infection. Few cases of pancreatitis occurring after bone marrow transplantation have been reported. All 4 patients presented with acute epigastric pain associated with transient elevation of serum amylase. The vesicular rash followed the presenting symptoms of severe abdominal pain by 8 days. This clinical presentation, occurring in immunocompromised patients, defines a set of symptoms which should lead the physician to suspect varicella-zoster pancreatitis, even in the initial absence of the characteristic skin vesicular eruption. Early institution of antiviral therapy seems mandatory.
我们报告了4例免疫功能低下宿主的水痘-带状疱疹性胰腺炎病例。所有4例患者均因慢性淋巴细胞增殖性疾病(主要是淋巴瘤和霍奇金病)以及长期免疫抑制治疗而出现严重免疫缺陷。水痘-带状疱疹性胰腺炎是水痘-带状疱疹感染的一种非常罕见的表现形式。骨髓移植后发生胰腺炎的病例报道较少。所有4例患者均出现急性上腹部疼痛,并伴有血清淀粉酶短暂升高。水疱疹在严重腹痛症状出现8天后出现。这种临床表现发生在免疫功能低下的患者中,定义了一组症状,即使最初没有特征性的皮肤水疱疹,也应使医生怀疑为水痘-带状疱疹性胰腺炎。早期开始抗病毒治疗似乎是必要的。