在Descemet膜内皮角质形成后,简单疹病毒与死性肝炎的传播
Ahad Azeem1, Brandon Baartman2, Christopher D Conrady3
1Department of Medicine, Creighton University School of Medicine and CHI Health, Omaha, NE, 68105, USA.
BMC infectious diseases
|July 12, 2023
概括
捐赠者的角膜可以传播单纯疹病毒 (HSV),导致移植受体患有严重的,危及生命的疾病. 早期检测和治疗传播的HSV感染对于患者的生存和康复至关重要.
科学领域:
- 眼科医生 眼科 眼科
- 传染性疾病 传染性疾病
- 移植 移植 移植 移植
背景情况:
- 角膜移植是一种常见的手术,频率越来越高.
- 捐赠者的角膜组织是罕见但已有证据证明的简单疹病毒 (HSV) 传播的来源.
- 通过供体角膜传播的HSV通常会导致移植失败和前视膜炎,而眼外疾病以前没有报告.
研究的目的:
- 报告一种罕见的生命危险的传播性简单疹病毒 (HSV) 病例,通过捐赠者的角膜组织传播.
- 突出角膜移植接受者HSV严重系统性并发症的潜力.
- 强调在角膜移植后无法解释的全身性疾病的差异诊断中考虑HSV的重要性.
主要方法:
- 一个老年免疫能力强的男性患者的病例报告,他接受了Descemet膜内皮质角膜整形手术 (DMEK).
- 详细的临床表现,实验室发现和诊断调查,包括在各种体液和体外组织中检测HSV DNA.
- 治疗方案包括静脉注射阿西克洛维尔,HLH导向疗法和重复角膜移植.
主要成果:
- 患者患有严重的全身性疾病,包括性肝炎,细胞衰竭,体溶解,急性功能衰竭,精神状态变化和血细胞淋巴细胞细胞瘤 (HLH).
- 在脑脊液,血液,角膜组织和前腔液中检测到高水平的HSVDNA,证实了源自供体移植的传播HSV感染.
- 及时治疗导致全身性疾病的解决,通过新移植恢复视力,并成功管理HSV感染.
结论:
- 捐赠者的角膜组织可以传播HSV,可能导致超出典型眼部表现的危及生命的传播性疾病.
- 为了及时诊断和有效管理,需要提高对通过捐赠者的角膜传播HSV的认识和调查.
- 这一案例强调了对角膜移植受体感染并发症的警的必要性.
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