NK-cell post-transplant lymphoproliferative disease with chronic active Epstein-Barr virus infection-like clinical findings.
NK-cell post-transplant lymphoproliferative disease with chronic active Epstein-Barr virus infection-like clinical findings.
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NK 细胞移植后淋巴增殖性疾病，具有慢性活动性 Epstein-Barr 病毒感染样临床表现。
DOI：
10.1016/j.ijid.2019.07.039
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发表时间：
2019
期刊：
影响因子：
--
通讯作者：
A. Takaori
中科院分区：
文献类型：
--
作者：
Tomoki Iemura;T. Kondo;M. Hishizawa;K. Yamashita;H. Kimura;A. Takaori
一名69岁的男子七年前接受了脐带血移植，因发烧、肝酶升高和血小板减少而入院。骨髓抽吸物显示噬血细胞性淋巴组织细胞增多症。病毒衣壳抗原(VCA)-免疫球蛋白(Ig)G、VCA-IgM、VCA-IgA、Epstein-Barr病毒核抗原-Ig G、早期抗原弥漫型和限制性(EA-DR)Ig G、Ea-DR Ig A滴度分别为2560、10、10、40、40和10。外周血EB病毒-脱氧核糖核酸实时定量聚合酶链式反应检测结果为240,000拷贝/μg DNA。流式细胞仪原位杂交证实EBV感染细胞为NK细胞。经EBV-DNA末端重复序列Southern印迹分析证实为双克隆性。因此，我们诊断出具有慢性活动性EB病毒感染样临床表现的NK细胞移植后淋巴增生性疾病(CAEBV样NK细胞PTLD)。虽然CAEBV样PTLD非常罕见，但其预后似乎非常差。在移植后出现持续性或复发性传染性单核细胞增多症样症状的患者应考虑这种疾病。
A 69-year-old man who underwent cord blood transplantation seven years ago was admitted because of fever, elevated liver enzymes and thrombocytopenia. Bone marrow aspirate revealed hemophagocytic lymphohistiocytosis. Viral capsid antigen (VCA)-immunoglobulin (Ig) G, VCA-IgM, VCA-IgA, Epstein–Barr virus nuclear antigen-IgG, early antigen-diffuse-type and restricted-type (EA-DR) IgG, and EA-DR IgA titers were 2560, <10, 10, 40, 40, and <10, respectively. Real-time polymerase chain reaction assay of peripheral whole blood for Epstein–Barr virus-deoxyribonucleic acid (EBV-DNA) revealed 240,000 copies/μg DNA. Flow cytometricin situhybridization assay confirmed that EBV-infected cells were NK-cells. Clonality evaluation by Southern blot assay of EBV-DNA terminal repeats proved to be bi-clonal. Accordingly, we made a diagnosis of NK-cell post-transplant lymphoproliferative disease with chronic active EBV infection-like clinical findings (CAEBV-like NK-cell PTLD). Although CAEBV-like PTLD is extremely rare, its prognosis seems to be very poor. The disease should be considered in such patients who present persistent or recurrent infectious mononucleosis-like symptoms after transplantation.
影响因子：
6.4
作者：
Kimura, Hiroshi;Miyake, Kanae;Nishiyama, Yukihiro
通讯作者：
Nishiyama, Yukihiro
影响因子：
12.8
作者：
Okano, M;Kawa, K;Imashuku, S
通讯作者：
Imashuku, S