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首页> 外文期刊>Journal of clinical virology: The official publication of the Pan American Society for Clinical Virology >Severe viral hepatitis in a patient with chronic lymphocytic leukemia (CLL) complicated with autoimmune hemolytic anemia (AIHA), treated with steroids
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Severe viral hepatitis in a patient with chronic lymphocytic leukemia (CLL) complicated with autoimmune hemolytic anemia (AIHA), treated with steroids

机译：接受类固醇治疗的慢性淋巴细胞性白血病（CLL）合并自身免疫性溶血性贫血（AIHA）的患者的严重病毒性肝炎

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摘要

Infectious complications are a major cause of morbidity and mortality in patients with chronic lymphocytic leukemia (CLL) due to impaired immunity secondary to the disease itself and to the immunosuppressive therapies administered to these patients. We report a 78-year-old woman with CLL who was treated with steroids for autoimmune hemolytic anemia (AIHA). A few weeks later, she was admitted for severe acute hepatitis with disseminated intravascular coagulation (DIC). Despite the symptomatic treatment of DIC, standard reanimation and probabilistic antibiotics, the patient died within 24 h with severe hepatic failure. Autopsy was in favor of a disseminated viral infection with esophageal, hepatic and pulmonary cytopathologic lesions with acidophilic intranuclear inclusions suggestive of herpes virus, even though HSV 1 and 2, CMV and HHV6 PCRs were negative. This case of severe viral hepatitis with esophagitis occurring three weeks after the introduction of high-dose steroid treatment for AIHA in a CLL patient calls for anti-herpetic prophylaxis in such patients, immunodepressed by their diseases and the treatment they receive. (C) 2014 Elsevier B.V. All rights reserved.
机译：传染性并发​​症是慢性淋巴细胞性白血病（CLL）患者发病和死亡的主要原因，原因是继发于疾病本身和对这些患者进行免疫抑制治疗后，免疫功能受损。我们报道了一名78岁的CLL妇女，该妇女接受了类固醇治疗自身免疫性溶血性贫血（AIHA）。几周后，她因弥散性血管内凝血（DIC）入院治疗重症急性肝炎。尽管采用DIC的对症治疗，标准复活和概率性抗生素治疗，但患者在24小时内死亡，并伴有严重的肝功能衰竭。尸检支持散布的病毒性食管，肝和肺细胞病理病变的传播，并伴有嗜酸性核内包裹物提示疱疹病毒，即使HSV 1和2，CMV和HHV6 PCR均为阴性。在CLL患者中对AIHA进行大剂量类固醇治疗后三周发生的这例严重的病毒性食管炎病毒性肝炎，要求对此类患者进行抗疱疹预防，并因其疾病和所接受的治疗而免疫抑制。 （C）2014 Elsevier B.V.保留所有权利。

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