移植后的淋巴增殖障碍呈现为大肠阻塞,导致分发性休克
Amy Wang1, Brendan Flynn2, Mary O'Donnell2
1General Surgery, Walter Reed National Military Medical Center, Bethesda, Maryland, USA amywang296@yahoo.com.
BMJ case reports
|March 25, 2025
概括
一位肝移植患者患上了艾普斯坦-巴尔病毒阳性移植后淋巴增殖障碍 (PTLD),呈现为西格体质. 尽管接受了治疗,但她经历了细胞因子释放的危及生命的并发症,突出了PTLD.
科学领域:
- 在瘤学瘤学.
- 移植医学 移植医学
- 胃肠病学 胃肠病学
背景情况:
- 移植后淋巴增殖障碍 (PTLD) 是器官移植后的一种严重并发症.
- 爱斯坦-巴尔病毒 (EBV) 是PTLD的常见触发因素,特别是在免疫抑制个体中.
- PTLD的临床表现可能是多样化和快速渐进的.
研究的目的:
- 报告一种罕见的PTLD病例,该病例在肝移植接受者身上呈现为阻塞性西格体质.
- 为了说明与EBV阳性PTLD相关的快速和严重的临床恶化.
- 强调移植患者中PTLD的诊断和管理挑战.
主要方法:
- 一个女性肝移植接受者呈现阻塞性症状的案例研究.
- 诊断工作包括成像,结肠镜检查和干预性放射学引导的活检.
- 组织病理学分析证实了扩散型大B细胞淋巴瘤类型的EBV阳性单形PTLD.
主要成果:
- 患者出现了严重的并发症,包括活检后出血和分布性休克.
- 分布性休克归因于淋巴瘤的次要大量细胞因子释放.
- 尽管急需化疗,但患者经历了耐火性血液动力学不稳定性,并被同情地抽出管道.
结论:
- 在移植接受者中,PTLD可以呈现异常,例如具有西格质量.
- 快速进展,可能发生危及生命的表现,包括细胞因子释放综合征.
- 早期识别和管理至关重要,尽管在严重的情况下,结果可能很差.
相关概念视频
Inflammatory Bowel Disease V: Surgical Management
70
Surgical interventions for inflammatory bowel disease (IBD), which includes ulcerative colitis and Crohn's disease, are essential in managing symptoms and addressing complications. The selection of surgical procedures is contingent upon the specific conditions and complications that stem from these illnesses.
Here are some common surgical interventions for IBD:
Here are some common surgical interventions for IBD:
70
Inflammatory Bowel Disease II: Crohn's Disease
141
Introduction
Inflammatory bowel disease, commonly known as IBD, refers to a collection of disorders that lead to persistent inflammation of the gastrointestinal tract. The two types of IBD are ulcerative colitis, which impacts the colon, and Crohn's disease, which can involve any part of the gastrointestinal segment.
Crohn's disease
Crohn's disease is a chronic, systemic inflammatory bowel disease (IBD) that predominantly affects the gastrointestinal tract. It is marked by...
Inflammatory bowel disease, commonly known as IBD, refers to a collection of disorders that lead to persistent inflammation of the gastrointestinal tract. The two types of IBD are ulcerative colitis, which impacts the colon, and Crohn's disease, which can involve any part of the gastrointestinal segment.
Crohn's disease
Crohn's disease is a chronic, systemic inflammatory bowel disease (IBD) that predominantly affects the gastrointestinal tract. It is marked by...
141
Inflammatory Bowel Disease I: Ulcerative Colitis
103
Introduction
Inflammatory bowel disease, or IBD, encompasses a group of disorders characterized by chronic inflammation or ulceration of the gastrointestinal tract.
Risk Factors
The exact cause of IBD remains unclear, although it is believed to be due to a mix of genetic, environmental, microbial, and immune factors. Genetic factors are significant in determining susceptibility to IBD, with family history being a critical risk factor. Individuals with a first-degree relative who has IBD are at...
Inflammatory bowel disease, or IBD, encompasses a group of disorders characterized by chronic inflammation or ulceration of the gastrointestinal tract.
Risk Factors
The exact cause of IBD remains unclear, although it is believed to be due to a mix of genetic, environmental, microbial, and immune factors. Genetic factors are significant in determining susceptibility to IBD, with family history being a critical risk factor. Individuals with a first-degree relative who has IBD are at...
103
Chronic Bowel Disorders: Introduction
374
Chronic bowel diseases are a group of long-term conditions affecting the digestive tract, characterized by inflammation and damage to the gut lining. These conditions primarily include irritable bowel syndrome and inflammatory bowel disease.
Irritable Bowel Syndrome (IBS) is a common disorder affecting the gastrointestinal tract. The distinctive feature is recurrent abdominal pain associated with altered bowel movements, manifesting as constipation, diarrhea, or fluctuating between both. The...
Irritable Bowel Syndrome (IBS) is a common disorder affecting the gastrointestinal tract. The distinctive feature is recurrent abdominal pain associated with altered bowel movements, manifesting as constipation, diarrhea, or fluctuating between both. The...
374


