Cerebral toxoplasmosis following etanercept treatment for idiophatic pneumonia syndrome after autologous peripheral blood progenitor cell transplantation (PBPCT)
Cerebral toxoplasmosis following etanercept treatment for idiophatic pneumonia syndrome after autologous peripheral blood progenitor cell transplantation (PBPCT)
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DOI：
10.1007/s00277-003-0705-2
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发表时间：
2003-08
影响因子：
3.5
通讯作者：
M. González-Vicent;M. Díaz;J. Sevilla;L. Madero
中科院分区：
文献类型：
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作者：
M. González-Vicent;M. Díaz;J. Sevilla;L. Madero
特发性肺炎综合征（IPS）是一个用于描述无感染病因的造血干细胞移植（HSCT）后肺损伤的术语。诊断标准包括胸部x线多叶浸润、符合肺炎的临床症状和肺生理异常的证据。自体移植后的发病率低（6%），但死亡率高（70-80%）。使用高剂量类固醇治疗，但结果令人沮丧。依那西普是一种重组人可溶性TNF受体融合蛋白，可抑制肿瘤坏死因子α (TNFα)的功能。近年来，依那西普在治疗HSCT后急性和慢性GVHD方面取得了令人满意的结果，但关于不良反应的信息很少。我们报告一例依那西普成功治疗自体外周血祖细胞移植（PBPCT）后的IPS。患者在依那西普治疗后立即出现脑弓形虫病，预后良好。
Idiophatic pneumonia syndrome (IPS) is a term used to describe lung injury following hematopoietic stem cell transplantation (HSCT) without an infectious etiology. Diagnostic criteria include multilobar infiltrates on chest X-ray, clinical symptoms consistent with pneumonia and evidence of abnormal pulmonary physiology. The incidence after autologous transplantation is low (6%) but it has a high mortality (70–80%). Treatment with high-dose steroids has been used but the results are discouraging. Etanercept is a recombinant human soluble TNF receptor fusion protein that inhibits tumor necrosis factor α (TNFα) function. Recently, promising results have been obtained with etanercept for the treatment of acute and chronic GVHD after HSCT, but there is a little information regarding adverse effects. We report a case of IPS after autologous peripheral blood progenitor cell transplantation (PBPCT) successfully treated with etanercept. The patient developed cerebral toxoplasmosis immediately after etanercept treatment with a good outcome.