Pancreatic hyperamylasemia and hyperlipasemia in association with cytomegalovirus infection following unrelated cord blood transplantation for acute myelogenous leukemia
Pancreatic hyperamylasemia and hyperlipasemia in association with cytomegalovirus infection following unrelated cord blood transplantation for acute myelogenous leukemia
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DOI：
10.1532/ijh97.06119
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发表时间：
2006-12-01
影响因子：
2.1
通讯作者：
Asano, Shigetaka
中科院分区：
文献类型：
--
作者：
Tomonari, Akira;Takahashi, Satoshi;Asano, Shigetaka
巨细胞病毒（CMV）相关的胰腺炎是罕见的异体造血干细胞移植（SCT）后。我们描述了一例脐带血移植（CBT）后发生与巨细胞病毒感染相关的胰腺高淀粉酶血症和高脂血症的患者。一例31岁急性髓性白血病患者接受CBT治疗。第21天中性粒细胞计数始终大于500/ μ L。+35和+67天CMV抗原血症阳性提示用更昔洛韦或氟膦酸钠进行2个疗程的预防性治疗。巨细胞病毒抗原血症值在第134天再次呈阳性。第141天，血清淀粉酶和脂肪酶活性分别显著提高至1221 IU/L和894 IU/L。患者无腹部症状。超声和计算机断层扫描结果显示胰腺未见异常。诊断可能为胰腺炎。开始氟膦酸钠治疗后，巨细胞病毒抗原血症结果很快变为阴性，血清淀粉酶和脂肪酶活性恢复正常。因此，巨细胞病毒感染被认为在本例患者胰腺高淀粉酶血症和高脂血症的发展中起主要作用。本报告表明，巨细胞病毒感染应纳入胰腺高淀粉酶血症患者SCT后的鉴别诊断。
Cytomegalovirus (CMV) -associated pancreatitis is rare after allogeneic hematopoietic stem cell transplantation (SCT). We describe a patient who developed pancreatic hyperamylasemia and hyperlipasemia in association with CMV infection after cord blood transplantation (CBT). A 31-year-old man with acute myelogenous leukemia underwent CBT. A neutrophil count consistently greater than 500/mu L was achieved on day +21. Positive results for CMV antigenemia on days +35 and +67 prompted 2 courses of preemptive therapy with ganciclovir or foscarnet. The CMV antigenemia value again became positive on day +134. On day +141, serum amylase and lipase activities markedly increased to 1221 IU/L and 894 IU/L, respectively. The patient had no abdominal symptoms. Ultrasonography and computed tomography results showed no abnormalities of the pancreas. A diagnosis of possible pancreatitis was made. After the initiation of foscarnet therapy, the CMV antigenemia results soon became negative, and serum amylase and lipase activities returned to normal. Therefore, CMV infection was considered to play a major role in the development of pancreatic hyperamylasemia and hyperlipasemia in our patient. The present report indicates that CMV infection should be included in the differential diagnosis for patients with pancreatic hyperamylasemia after SCT.