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移植相关的移植与宿主疾病对比

Issa Al Salmi¹, Ehab Mohammed², Salam Al Kindi³

¹Department of Renal Medicine, The Royal Hospital; Department of Medicine, Oman Medical Specialty Board, Aziabah, Muscat, Oman.

Saudi journal of kidney diseases and transplantation : an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia

|November 6, 2023

概括

移植与宿主疾病 (GVHD) 在实体器官移植后很罕见. 这一案例突显了移植相关的GVHD在接受者呈现肝功能障碍和全细胞衰竭.

科学领域:

免疫学免疫学免疫学
移植医学移植医学
胃肠病学胃肠病学

背景情况:

移植与宿主疾病 (GVHD) 在造血细胞移植后很常见,但在实体器官移植后很少见.
GVHD涉及捐赠免疫细胞攻击宿主组织,主要观察到肝脏,小肠和胰腺移植.
这个案例重点关注的是移植接受者经历了延迟的GVHD呈现.

研究的目的:

在移植接受者中呈现一种罕见的移植相关的GVHD (ta-GVHD).
强调肝脏功能障碍的移植后患者ta-GVHD的诊断考虑.
要突出治疗ta-GVHD的临床表现和挑战.

主要方法:

一个54岁的男性脏移植接受者的病例报告.
临床评估,包括实验室测试 (肝酶,全细胞衰竭) 和成像.
肝脏活检用于组织病理学诊断.
对临床表现,实验室,放射学和病理学发现的审查,以确认ta-GVHD.

主要成果:

患者患有黄,厌食症,腹和腹痛三年后的移植.
实验室发现显示肝酶升高和严重的胰腺缩与肝炎.
肝活检证实了移植对宿主疾病和毒性肝炎,导致了移植相关GVHD的诊断.

结论:

移植相关的GVHD应高度考虑在免疫功能受损的患者呈现跨氨炎/高 bilirubinemia,特别是在排除药物诱导的肝损伤后.
延迟诊断和患者不合作使管理复杂化,导致严重的败血症和患者死亡.
这一案例凸显了对实体器官移植受体中ta-GVHD等罕见并发症的警的重要性.

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