异基因造血干细胞移植后可逆性后部白质脑病综合征1例并文献复习  

Posterior reversible encephalopathy syndrome after allogeneic hematopoietic stem cell transplantation:report of 1 case and review of literature

作　　者：耿楼 王扬 徐许 生晶 陈洁 Geng Lou;Wang Yang;Xu Xu;Sheng Jing;Chen Jie(Department of Hematology,Changhai Hospital,Naval Medical University,Shanghai 200433,China;Department of Medical Imaging,Changhai Hospital,Naval Medical University,Shanghai 200433,China)

机构地区：[1]海军军医大学长海医院血液内科,上海200433 [2]海军军医大学长海医院影像医学科,上海200433

出　　处：《白血病．淋巴瘤》2024年第5期283-287,共5页Journal of Leukemia & Lymphoma

基　　金：国家自然科学基金(81970178、82300257);上海市"科技创新行动计划"生物医药科技支撑专项(21S11906100);上海长海医院"长风"项目。

摘　　要：目的提高对异基因造血干细胞移植(allo-HSCT)后可逆性后部白质脑病综合征(PRES)的认识。方法回顾性分析2022年11月海军军医大学长海医院收治的1例allo-HSCT后发生PRES患者的病史、诊疗经过、实验室检查和影像学检查结果,并复习相关文献。结果患者为33岁女性,因确诊再生障碍性贫血17年,行同胞全相合allo-HSCT后1个月,低热1周入院。入院第7天出现突发癫痫,结合头颅磁共振成像(MRI)及其他相关检查,排除脑部器质性病变,考虑PRES,予降压、抗癫痫、抗感染等治疗后好转。发病后3个月复查头颅增强MRI提示病灶消失。结论对于allo-HSCT后发生的PRES,尽早诊断和治疗可获得良好预后。Objective To advance the understanding of posterior reversible encephalopathy syndrome(PRES)after allogeneic hematopoietic stem cell transplantation(allo-HSCT).Methods The medical history,diagnosis and treatment process,laboratory examination and imaging examination results of a patient who developed PRES after undergoing allo-HSCT at Changhai Hospital of Naval Medical University in November 2022 were retrospectively analyzed,and the relevant literature was reviewed.Results The patient was a 33-year-old woman,and she was admitted to the hospital with 17 years of diagnosis of aplastic anemia,1 month after sibling-matched allo-HSCT,with low-grade fever for 1 week.On the 7th day of hospitalization,the patient experienced a sudden onset of seizures.After combining findings from cranial magnetic resonance imaging(MRI)and other relevant examinations,organic brain lesions were ruled out,and PRES was considered.The patient's condition improved after receiving antihypertensive,antiepileptic,anti-infection,and other appropriate treatments.A follow-up cranial enhanced MRI was performed 3 months after the onset of symptoms revealed the disappearance of lesions.Conclusions PRES after allo-HSCT has the potential to yield favorable outcomes when it is promptly diagnosed and treated.

关 键 词：造血干细胞移植 可逆性后部白质脑病综合征 癫痫 诊断 治疗结果 

分 类 号：R457.7[医药卫生—治疗学] R747.9[医药卫生—临床医学]