移植后的一种罕见的血质髓瘤病例
Sabir Sulejman1, Ardian Memeti, Vlora Sadiku
1>From the University Clinic for Nephrology, Faculty of Medicine, Saints Cyril and Methodius University in Skopje, Skopje, North Macedonia.
概括
这份病例报告详细介绍了一个罕见的血质髓瘤病例,一种侵袭性癌症,在移植接受者身上发展. 早期诊断和治疗对于移植后的血细胞瘤至关重要.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 在瘤学瘤学.
- 移植免疫学 移植免疫学
背景情况:
- 移植后的淋巴增殖性疾病 (PTLD) 是固体器官移植 (SOT) 后的一个重要并发症.
- 血细胞瘤 (PCN) 是SOT接受者的罕见但严重的并发症.
- 血性骨髓瘤 (PBM) 是多发性骨髓瘤的一个侵袭性变体,预后不佳.
研究的目的:
- 在移植接受者中报告一种罕见的PBM病例.
- 突出诊断挑战和PBM在移植后环境中的侵略性临床过程.
- 强调在SOT患者呈现异常症状时考虑PBM的重要性.
主要方法:
- 一个41岁的男性移植接受者的案例报告.
- 临床表现,实验室检查 (包括高血症,肌水平升高,贫血) 和骨髓活检与免疫组织化学 (CD138阳性).
- 通过PCR排除爱斯坦-巴尔病毒 (EBV).
主要成果:
- 移植后56个月,该患者出现了混乱,体重减轻,高血症,肌素水平升高和贫血.
- 骨髓活检证实了有超过80%CD138+细胞的血质髓瘤.
- 尽管进行了血液透析,但患者的病情迅速恶化,并因急性心力衰竭和肺而死亡.
结论:
- 在实体器官移植接受者中,PBM是一种非常罕见且具有攻击性的并发症.
- 在免疫抑制患者中,PCN可以异常呈现,并具有快速的过程.
- 迅速识别和多学科管理对于改善这些具有挑战性的案件的结果至关重要.
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