通过腰部穿刺进行第一个梅托雷克萨特治疗后的大脑静脉血栓形成,这是在患有大B细胞淋巴瘤的患者身上
Aicha Ben Kahla1, Olfa Kassar1, Khadija Moalla2
1Department of Hematology. University Hedi Chaker Hospital, University of Sfax, Tunisia.
La Tunisie medicale
|March 6, 2024
概括
大脑静脉血栓形成是一个罕见的并发症,用于内治疗的腰部穿刺. 早期的神经学评估和及时的抗凝治疗对于在淋巴瘤患者中管理这种情况至关重要.
科学领域:
- 血液学 血液学 血液学
- 神经学 神经学
- 在瘤学瘤学.
背景情况:
- 大脑静脉血栓塞 (CVT) 是一种罕见但严重的椎穿刺 (LP) 后的并发症.
- 接受IT化疗的患者,特别是患有血液性恶性瘤的患者,如扩散性大B细胞淋巴瘤 (DLBCL),可能会增加风险.
- 与恶性瘤或其治疗相关的凝血病可以进一步提高血栓事件的风险.
研究的目的:
- 报告一例脑静脉血栓形成病例,该病例发生在一种患有扩散性大B细胞淋巴瘤的患者,该病例发生在甲状腺内注射甲状腺后.
- 强调认识到神经症状作为腰部穿刺的潜在并发症的重要性.
- 强调需要及时进行神经学转诊和适当的抗凝管理.
主要方法:
- 一个患有DLBCL的患者的病例报告,在IT甲索特雷克萨后发展了CVT.
- 终止内治疗. 停止内治疗.
- 用高剂量低分子量肝素 (LMWH) 治疗,通过皮下注射.
主要成果:
- 患者在接受皮下LMWH治疗后成功康复.
- 经过静脉内注射甲索特雷克萨特后,观察到表明CVT的神经症状.
- 停止致病性内治疗是管理的一个关键步骤.
结论:
- 血液学家应警在接受IT治疗的患者中出现暗示CVT的神经症状,特别是那些有先前存在的凝血病患者.
- 早期转诊神经科医生对于及时诊断和管理至关重要,以防止致命的结果或神经学缺陷.
- 在这种临床背景下,低分子量肝素是CVT的有效治疗方法.
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