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疹简单病毒肝炎在脏移植接受者的血清阴性移植前肝炎
Vivian V Nguyen1, Konstantin Koro2, Carla S Coffin2
1Department of Medicine, University of Alberta Faculty of Medicine, Edmonton, Alberta, Canada.
Canadian liver journal
|December 25, 2023
概括
简单疹病毒 (HSV) 肝炎是免疫受损患者罕见但致命的并发症. 早期诊断和阿西克洛维尔治疗对于接受脏移植的患者的生存至关重要.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 移植免疫学 移植免疫学
- 病毒学 病毒学
背景情况:
- 简单疹病毒 (HSV) 是一种罕见的急性病毒性肝炎的原因,主要影响免疫力低下的人.
- 由于HSV肝炎的死亡率很高,因此需要迅速识别和管理.
- 这一案例突出显示了一名年轻的女性移植接受者患有严重膜炎的HSV肝炎.
研究的目的:
- 在移植接受者中报告单纯疹病毒肝炎病例.
- 描述所采用的诊断策略和治疗干预措施.
- 强调在移植患者中早期检测和治疗HSV肝炎的重要性.
主要方法:
- 进行了全面的实验室,血清学和分子病毒检测.
- 骨髓活检是由于最初怀疑是血细胞性淋巴细胞瘤 (HLH) 而进行的.
- 进行了肝脏活检,以HSV血清学和升高的透氨酶为指导,证实了HSV肝炎.
主要成果:
- 患者表现出转氨酶 (ALT,AST) 和费里丁水平显著升高,峰值为ALT 6609 U/L和AST 6525 U/L.
- 骨髓活检没有揭示明确的HLH.
- 血液中的HSV-DNAPCR呈阳性,并开始静脉注射阿西克洛维尔;肝活检证实HSV肝炎.
结论:
- 简单疹病毒肝炎需要在移植受体中具有无法解释的肝功能障碍的高度怀疑指数.
- 移植前的HSV状态评估和适当的抗病毒预防是关键的预防措施.
- 及时启动抗病毒疗法,如阿西克洛维尔,对于改善HSV肝炎的结果至关重要.
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