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首页> 外文期刊>感染症学雑誌 >高熱,リンパ節腫脹を繰り返したのち発症したHIV-1陽性HHV-8関連Castleman病の1例
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高熱,リンパ節腫脹を繰り返したのち発症したHIV-1陽性HHV-8関連Castleman病の1例

机译：HIV-1阳性HHV-8相关的Castleman病人的病例，重复高温，淋巴结肿胀

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A 48-year-old man infected with an HIV-1 experienced intermittent bouts of fever, lymphadenopathy, elevated CRP level, and thrombocytopenia, each lasting about 2 weeks, and recurring at 2-3 month intervals, His CD4 count was about 500/uL, and he had never received antiretroviral therapy(ART). In March 2005, he experienced the same symptoms, accompanied by liver damage, splenomegaly, pleural fluid, and a high serum soluble IL-2 receptor level. Examination of a cervical lymph node specimen resulted in a diagnosis of Castleman disease, plasma cell type,, Immunohistochemical studies confirmed the presence of HHV-8 and Ebstein-Barr virus(EBV), Since the plasma HHV-8 DNA and serum IL-6 were elevated during the flare-up, were negative between episodes, he was treated with ART to control the Castleman disease. He remained asymptomatic for 3 months, but, similar symptoms recurred with a high level of HHV-8 DNA in his PBMCs,, Oral valganciclovir was them started at l,800mg twice daily, and his symptoms immediately improved. The HHV-8 DNA level in the PBMCs decreased markedly over the course of 4 weeks, and valganciclovir was discontinued. One week later, he experienced another flare-up, and was successfully treated with 10 days of valganciclovir l,800mg, followed by maintenance with valganciclovir 900mg. ART was discontinued, because the valganciclovir plus ART caused severe fatigue. No subsequent flare-ups have been observed, and, no HHV-8 DNA has been detected in his PBMCs, Castleman disease is an unusual complication in patients with HIV-1 and HHV-8 infection, but it should be included in the differential diagnosis of patients who exhibit a relapsing systemic inflammatory syndrome and lymphoadenopathy. Further study is needed to determine the appropriate usage and timing of the anti-HHV-8 and HIV-1 medication
机译：一个48岁的男子感染了HIV-1经验丰富的性间歇性发烧，淋巴结病，升高的CRP水平和血小板减少，每次持续2周，并在2-3个月间隔内进行重复，他的CD4计数约为500 / UL，他从未接受过逆转录病毒治疗（艺术品）。 2005年3月，他经历了相同的症状，伴有肝损伤，脾肿大，胸膜液和高血清可溶性IL-2受体水平。检查颈淋巴结标本导致诊断血浆疾病，血浆细胞类型，免疫组化研究证实了HHV-8和EBSTEIN-BART病毒（EBV）的存在，因为血浆HHV-8 DNA和血清IL-6在爆发期间升高，发作之间是负面的，他被艺术治疗，以控制卡斯勒氏病。他仍然无症状为3个月，但是，在他的PBMC中具有高水平的HHV-8 DNA症状，口腔Valganciclovir每天两次在L，800mg两次开始，他立即改善了他的症状。在4周的过程中，PBMC中的HHV-8 DNA水平显着下降，瓦尔加昔洛韦被停产。一周后，他经历了另一个火炬，并用10天的Valganciclovir L，800毫克成功治疗，然后用Valganciclovir 900mg进行维持。艺术被停产，因为Valganciclovir加艺术引起严重的疲劳。没有观察到随后的爆发，并且在他的PBMC中没有检测到HHV-8 DNA，Castleman疾病是HIV-1和HHV-8感染患者的一种不寻常的并发症，但它应该包含在鉴别诊断中表现出复发全身性炎症综合征和淋巴细胞病的患者。需要进一步研究以确定抗HHV-8和HIV-1药物的适当使用和定时

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