炎症性肠道疾病 随着异构血造细胞移植用于状细胞疾病的炎症性肠道疾病
Emily Rowland1, Akshay Sharma2, Samantha Paglinco3
1Department of Pediatric Hematology, Oncology, Blood and Marrow Transplant, Nationwide Children's Hospital, Columbus, Ohio, USA.
Pediatric blood & cancer
|October 21, 2025
概括
移植与宿主疾病 (GvHD) 在干细胞移植后可能导致具有挑战性的胃肠道问题. 这项研究突出了状细胞患者移植后罕见的炎症性肠病类症状,强调了需要更广泛的诊断考虑.
科学领域:
- 血液学 血液学 血液学
- 胃肠病学 胃肠病学
- 免疫学 免疫学 免疫学
背景情况:
- 胃肠道 (GI) 并发症在全源造血干细胞移植 (HCT) 后很常见.
- 移植与宿主疾病 (GvHD) 是胃肠道问题的常见原因,但其症状可能是非特异性的,使诊断复杂化.
- 在HCT后持续的胃肠道症状时,应考虑替代诊断.
研究的目的:
- 描述一个罕见的表现的炎症性肠病 (IBD) 类似的表现在状细胞疾病患者后HCT.
- 强调将IBD视为HCT后胃肠道并发症的差异诊断的重要性,与GvHD不同.
主要方法:
- 三名状细胞病患者的病例系列,他们接受了全基性HCT.
- 慢性腹和内镜活检的临床评估.
- 结肠活检的组织病理学分析,以评估GvHD和其他炎症变化.
主要成果:
- 三名患者在HCT后4-18个月出现了慢性腹和IBD类症状.
- 活检显示了广泛的结肠和非死性颗粒瘤,GvHD最小.
- 症状通过IBD导向治疗得到缓解,这表明了另一个病因.
结论:
- 炎症性肠病 (IBD) 应考虑在所有原性HCT后胃肠道并发症的差异诊断中,特别是在状细胞病患者中.
- 组织病理学发现可能模仿GvHD,但可以代表其他炎症过程.
- 及时识别和IBD特异性治疗可以导致症状的消失.
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