血巨细胞病毒抗原阴性的急性髓细胞白血病的初期症状分析  

Analysis of the Initial Symptoms of Acute Myeloid Leukemia Patients with Blood CMV Antigen-negative

作　　者：薄立魁[1] 

机构地区：[1]辽宁省铁岭市中心医院血液科,112000

出　　处：《中国医药指南》2010年第3期13-14,共2页Guide of China Medicine

摘　　要：目的分析血巨细胞病毒(CMV)抗原阴性的急性髓细胞白血病的初期症状。方法回顾性分析2007年铁岭市中心医院血液科收治的1例既往有2年糖尿病史,因患结肠炎,伴有感染性休克及全血细胞减少症的35岁男性患者的临床资料。结果CMV感染是否作为结肠炎病因仍然存在争议,但是通过本例病理活检证实的CMV感染的小肠炎患者,我们认为CMV相关的中性粒细胞减少性结肠炎可为白血病的初期症状。结论根据我们的病例中性粒细胞减少性结肠炎可以发生在急性白血病患者化学治疗之前。CMV相关的中性粒细胞减少性结肠炎是对于盲肠炎患者,尤其为拒绝支持治疗或接受广谱抗生素治疗患者的重要的鉴别诊断。Objective To analysis the Cytomegalovirus-related neutropenic enterocolitis with negative CMV antigenemia as the initial presentation in an acute myeloid leukemia patient. Methods Retrospectively analysis of clinical data from 2007 about a 35-year-old gentleman, with the past history of diabetes mellitus for 2 years, because of cecal enterocolitis with septic shock and pancytopenia in Tieling central hospital. Results In this case, no remarkable past history is noted, except the diabetes mellitus which may contribute to the occurrence of CMV colitis. Although the role of CMV as a primary pathogen of typhlitis in this patient is disputed, we describe the rare case of neutropenic enterocolitis associated with tissue-proven CMV infection as the initial presentation of disease： CMV colitis often presented with symptoms of watery or bloody diarrhea, abdominal pain with cramps, and fever. No other common presentations of CMV colitis, such as watery or bloody diarrhea, were noted in this patient except abdominal pain. Conclusion According to our case, neutropenic enterocolitis could develop before any chemotherapy for acute leukemia. The CMV-related enterocolitis should also be considered as the differential diagnosis in patients with typhlitis, especially in those resistant to supportive treatments and use of broad-spectrum antibiotics.

关 键 词：巨细胞病毒 抗原 阴性 白血病 

分 类 号：R733.7[医药卫生—肿瘤]