本地BK多瘤病毒脏病在一个正确心脏移植患者
Zachary M Thompson1, George Ajene1, Prathit A Kulkarni1
1Baylor College of Medicine, Houston, TX, USA.
概括
在非脏固体器官移植受体的本土脏中,BK多瘤病毒脏病 (BKVN) 可能发生,甚至在移植后数年. 这种罕见的疾病需要在患有渐进性功能障碍和尿生殖系统问题的患者中考虑.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 移植医学 移植医学 移植医学
- 病毒学 病毒学
背景情况:
- 乙基多重瘤病毒病 (BKVN) 是移植功能障碍的常见原因,通常在第一年内发生.
- 在非脏固体器官移植 (NRSOT) 接受者的本土脏中,BKVN是罕见的,特别是在移植后的几年,在急性损伤差异中经常被忽视.
研究的目的:
- 为了突出一个罕见的BK多重瘤病毒脏病的病例,在一个有心脏移植病史的患者身上.
- 强调在NRSOT患者中考虑BKVN的重要性,这些患者呈现出进展性功能障碍,特别是同时出现生殖尿路病理.
主要方法:
- 一个75岁的男性心脏移植接受者的病例报告,患有进展性功能障碍.
- 诊断评估包括脏活检,证实了多重瘤病毒炎和血清BK病毒载量升高.
- 治疗涉及免疫抑制降低和 leflunomide 启动.
主要成果:
- 这位患者在心脏移植13年后呈现出渐进性功能障碍,与阻塞性结症和尿管支架相吻合.
- 脏活检证实了BK多重瘤病毒炎与BK病毒载量升高.
- 尽管进行了治疗干预,但病毒清除并未实现,导致逐渐下降和临终关怀.
结论:
- 在移植后很长一段时间内,BK多重瘤病毒脏病可以在NRSOT患者的本土脏中表现出来.
- 临床医生应考虑BKVN在NRSOT患者渐进性功能障碍的差异诊断中,特别是那些有尿生殖系统疾病或尿路支架患者.
- 免疫抑制强度和尿路支架是BKVN的确定的危险因素.
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