首页|以心悸为首发症状的儿童急性淋巴细胞白血病造血干细胞移植后合并巨细胞病毒脑炎1例报告

以心悸为首发症状的儿童急性淋巴细胞白血病造血干细胞移植后合并巨细胞病毒脑炎1例报告

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造血干细胞移植后合并巨细胞病毒脑炎罕见且致命,病死率可高达90%以上.巨细胞病毒脑炎罕见且缺乏特异性的临床表现,临床诊断较为困难.本文首次报道1例儿童急性淋巴细胞白血病移植后早期(移植后81 d)出现巨细胞病毒脑炎,以心悸为首发症状,临床进展快,治疗效果不佳.该病例可促进临床医生进一步认识造血干细胞移植后中枢神经系统并发症的高危因素和临床特征,对待无诱因的心率增快,即使没有脑炎相关典型神经系统表现,仍需要警惕颅内感染的可能,早期识别和处理可能会改善此类患者的结局.
Cytomegalovirus Encephalitis Presenting With Palpitations as the Initial Symptom After Hematopoietic Stem Cell Transplantation to Treat Acute Lymphoblastic Leukemia in a Child:A Case Report
Hematopoietic stem cell transplantation(HSCT)patients may develop cytomegalovirus encephalitis,a rare but life-threatening complication with a mortality rate exceeding 90%.Cytomegalovirus encephalitis is rare and does not have specific clinical manifestations,which makes clinical diagnosis more difficult.This article reports a pediatric case of acute lymphoblastic leukemia(ALL)with early onset(81 d after transplantation)cytomegalovirus encephalitis after HSCT,with palpitations presenting as the initial symptom.The patient exhibited rapid clinical progression and the treatment was ineffective.This case report can help clinicians gain further understanding of the high-risk factors and clinical features of central nervous system complications following HSCT.When encountering unexplained tachycardia,clinicians should still be vigilant for the possibility of intracranial infection even in the absence of typical neurological manifestations associated with encephalitis.Early recognition and management may help improve the outcomes of such patients.

Acute lymphoblastic leukemiaChildHematopoietic stem cell transplantationCytomegalovirus infectionEncephalitis

陈禹霖、张晓萍、肖玲、乔莉娜、何国倩

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四川大学华西第二医院儿科(成都 610041)

出生缺陷与相关妇儿疾病教育部重点实验室(四川大学)(成都 610041)

隆昌市人民医院儿科(隆昌 642105)

四川大学华西临床医学院(成都 610044)

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急性淋巴细胞白血病 儿童 造血干细胞移植 巨细胞病毒感染 脑炎

2024

四川大学学报(医学版)
四川大学

四川大学学报(医学版)

CSTPCD北大核心
影响因子:0.961
ISSN:1672-173X
年,卷(期):2024.55(6)