在双边肺移植患者中,叶酸缺乏和药物诱导的严重泛细胞衰竭
Nathan M Au-Yeung1, Nicholas S Regennitter1, Jacob Stepherson2
1Hospital Medicine, Ochsner Clinic Foundation, New Orleans, USA.
Cureus
|August 30, 2024
概括
一个肺移植患者的严重泛细胞衰竭成功地用叶酸替代和药物调整来治疗. 这一案例凸显了叶酸缺乏是移植患者罕见但可治疗的泛cytopenia的原因.
科学领域:
- 血液学 血液学 血液学
- 移植医学 移植医学 移植医学
- 营养科学 营养科学
背景情况:
- 叶酸对于DNA合成至关重要;缺乏叶酸会导致巨核细胞贫血.
- 泛cytopenia 是叶酸缺乏的一个罕见表现.
- 移植接受者可能有独特的营养缺陷风险因素.
研究的目的:
- 在双边肺移植接受者中报告一例罕见的由于叶酸缺乏而导致的严重泛cytopenia.
- 强调在移植后的血液异常中考虑营养缺乏的重要性.
- 为了说明在免疫功能低下的患者中,叶酸缺乏引起的胰岛素衰竭的成功管理.
主要方法:
- 74岁的双边肺移植接受者的临床表现,患有临床失眠和全细胞衰竭.
- 实验室检查包括周围血液涂抹,骨髓活检和营养水平评估.
- 管理涉及持有可疑药物,叶酸替代剂和血液产品输血.
主要成果:
- 在骨髓中发现了严重的泛cytopenia与明显的trilineagehypoplasia.
- 叶酸缺乏被证实是原因,在外周涂抹上排除了恶性状细胞作为恶性.
- 随着叶酸替代和药物调整,患者的血液样本显著改善; 排泄是没有事件的.
结论:
- 叶酸缺乏是罕见但关键的泛细胞衰竭的原因,可能发生在肺移植接受者中.
- 及时诊断和治疗叶酸补充剂和药物审查对于恢复至关重要.
- 泛cytopenia的复发,即使较轻和自我限制,也需要进一步调查潜在的潜在原因.
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