在手术后的性结肠炎中治疗耐火性炎的Infliximab疗法后,水的发展
Kae Ishii1, Shuko Iwatani1, Takuro Kawaguchi1
1Department of Gastroenterology, Osaka International Medical and Science Center, Osaka Keisatsu Hospital, Japan.
Internal medicine (Tokyo, Japan)
|April 30, 2025
概括
一名因性结肠炎而接受Infliximab (IFX) 治疗的青少年患者患上了一种罕见的疹病毒 (VZV) 感染. 这一案例凸显了在免疫抑制患者中考虑VZV再激活的重要性.
科学领域:
- 胃肠病学 胃肠病学
- 免疫学 免疫学 免疫学
- 传染性疾病 传染性疾病
背景情况:
- 性结肠炎 (UC) 是一种慢性炎症性肠病.
- 带有阴道囊-门解剖 (IPAA) 的直肠切除术是耐火性UC的外科选择.
- 皮囊炎,皮质囊的炎症,可以发生在手术后.
- 免疫抑制疗法,如infliximab (IFX),用于管理IBD及其并发症.
研究的目的:
- 报告一种罕见的发生在接受性结肠炎并发症治疗的青少年患者中疹病毒 (VZV) 再激活的病例.
- 强调需要考虑VZV感染的免疫抑制患者表现为膀性皮疹的需要.
主要方法:
- 一个青少年患有性结肠炎的病例报告.
- 审查患者的病史,包括直肠切除术和用infliximab (IFX) 治疗.
- 临床表现评估,包括发烧和一般性皮疹.
- 在水泡中诊断证实Varicella zoster病毒 (VZV) 抗原阳性.
- 评估VZV疫苗接种史,环境暴露和VZV抗体标位.
主要成果:
- 在IFX注射两天后,患者发烧和普遍性皮疹.
- 在泡液中,VZV抗原呈阳性,证实了水感染.
- 尽管有VZV疫苗接种史,但基于临床背景和抗体标位,人们怀疑VZV的活性化.
- 由于治疗性结肠炎和囊炎,该患者免疫抑制.
结论:
- 麻疹病毒 (Varicella zoster virus,VZV) 的重新激活,呈现为麻疹,可以发生在免疫抑制患者中,即使是那些先前接种疫苗的人.
- 这一案例强调了在接受免疫抑制疗法治疗炎症性肠道疾病的患者中保持对VZV感染的高怀疑指数的重要性.
- 早期诊断和适当的治疗对于这种罕见病例的结果至关重要.
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