[在患有扩散型大B细胞淋巴瘤的患者中使用长效颗粒细胞殖民地刺激因子后出现的大血管血管炎]
Maki Matsumoto1, Hidetomo Takakura1, Yuichiro Usui1
1Department of Hematology and Oncology, Kita-Harima Medical Center.
[Rinsho ketsueki] The Japanese journal of clinical hematology
|November 1, 2023
概括
药物诱导的大血管血管炎是化学疗法中使用的长效粒细胞群刺激因子 (G-CSF) 的罕见并发症. 在G-CSF患者中发烧和大动脉壁加厚需要考虑这种情况.
科学领域:
- 在瘤学瘤学.
- 免疫学 免疫学 免疫学
- 放射学 放射学是一门学科.
背景情况:
- 扩散性大B细胞淋巴瘤 (DLBCL) 是一种血液性恶性瘤.
- 化疗方案通常包括预防药物,以减轻副作用.
- 长效颗粒细胞殖民地刺激因子 (G-CSF) 的佩格菲尔格拉斯蒂姆用于预防中性衰竭.
研究的目的:
- 报告一种药物诱导的大血管血管炎的病例.
- 为了突出长期作用的G-CSF的罕见不良影响.
- 强调在化疗期间有不明原因发烧的患者考虑主动脉炎的重要性.
主要方法:
- 一名75岁的DLBCL男性患者接受了佩格菲尔格拉斯蒂姆的预防.
- 研究了持续发烧和头痛的临床表现.
- 进行了诊断成像,包括胸部和大动脉的计算机断层扫描 (CT).
- 进行了血液培养和自身抗体血清学.
- 评估了对葡萄糖皮质醇治疗的反应.
主要成果:
- 患者在服用佩格菲尔格拉斯蒂姆后出现持续发烧和头痛.
- CT显示大动脉门壁的加厚和增强,暗示血管炎.
- 通过负面调查,感染和自身免疫原体疾病被排除在外.
- 确立了药物诱导的大血管血管炎的诊断.
- 症状和成像检测结果通过普雷迪尼索隆治疗得到解决.
结论:
- 长期起作用的G-CSF可以诱导大血管血管炎,呈现为关节炎.
- 接受化疗和G-CSF预防的患者发烧需要仔细评估.
- 在这种情况下,在无法解释的发烧的差异诊断中应考虑甲状腺炎.
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