成功治疗不典型移植相关血栓性微血管病1例附文献复习  

Atypical Transplantation Related Thrombotic Microangiopathy: a case report with literature review

作　　者：孙梅[1] 顾健[1] 姜扬文[1] 何斌[1] 裴孝平[1] 陈沛帅[1] 马莉[1] 吴蔚[1] 倪军[1] 

机构地区：[1]江苏省苏北人民医院扬州市血液学研究所,扬州225001

出　　处：《血栓与止血学》2014年第5期255-257,共3页Chinese Journal of Thrombosis and Hemostasis

摘　　要：目的观察异基因造血干细胞移植后血栓性微血管病的临床特征,探讨早期诊断指标,以便及早诊断和治疗。方法回顾性分析1例急性白血病患者,接受同胞全相合异基因造血干细胞移植后并发血栓性微血管病的临床表现及治疗转归。结果该患者出现神经系统症状、黄疸、贫血、肾损害,乳酸脱氢酶、D-D聚体升高,诊断血栓性微血管病,停用环孢素、他克莫司,给予大剂量甲强龙联合血浆置换,治疗后病情稳定。结论血栓性微血管病是异基因造血干细胞移植后严重并发症,及早诊断和治疗能改善预后。Objective To observe the clinical features of transplantation related thrombotic microangiopathy（TA-TMA） after allogeneic hematopoietic stem cell transplantation,to explore early diagnosis index for early diagnosis.Methods Retrospectively analyzed the clinical manifestations and treatment outcomes of 1 patient with acute leukemia,who was concurrent thrombotic microangiopathy afer accepting compatriots in total allogeneic hematopoietic stem cell transplantation.Results The patient had nervous system symptoms,jaundice,anemia,Renal damage,the level of lactate dehydrogenase and D-dimei elevated.So the patient was diagnosed as TMA,the cyclosporin A and tacrolimus were stopped.then the treatment was changed to high-dose methylpredniso-lone combined with plasma exchange.The illness became stable after treatment.Conclusion TMA was severe complication after allogeneic hematopoietic stem cell transplantation,early diagnosis and treatment can improve prognosis.

关 键 词：造血干细胞移植 血栓性微血管病 

分 类 号：R543.7[医药卫生—心血管疾病]