小儿异基因造血干细胞移植术后并发溶血尿毒综合征1例并文献复习

One case report and literature review of hemolytic uremic syndrome following allogeneic hematopoietic stem cell transplantation

目的报道1例重型地中海贫血(TM)患儿行非血缘供者造血干细胞移植(HSCT)术后并发溶血尿毒综合征(HUS)的临床特点、治疗及随访,提高对该并发症的认识。方法回顾性分析广州市妇女儿童医疗中心1例TM患儿HSCT后发生HUS的临床资料,复习国内外相关文献。结果重型TM患儿行非血缘供者外周干细胞移植术后7个月出现溶血性贫血,伴血小板减少,进而出现肾功能衰竭,予停用环孢素,应用糖皮质激素联合美罗华免疫抑制和连续性肾脏替代血液滤过等综合治疗,获得痊愈。结论应用糖皮质激素联合美罗华免疫抑制和连续性肾脏替代血液滤过等综合治疗,可以有效治疗HSCT术后并发HUS。

Objective To report the clinical features, treatment and follow-up of one patient with hemolytic uremic syndrome （HUS） following allogeneic hematopoietic stem cell transplantation（ HSCT）, and enhance the recognition of this rare disease in clinical practice. Methods The clinical features, treatment and follow up data of a case diagnosed as HUS after HSCT in our hospital were analyzed, and related literatures were reviewed. Results A 3-years old boy who had severe thalassemia major underwent allogeneic HSCT in Guangzhou Women and Children＇ s Medical Center. He suffered from hemolytic anemia, thrombocytopenia, and renal failure within 7 months after transplantation. Conclusions CsA was stopped and Combined treatment including glucocorticoids, mycophenolate , rituximab and continuous renal replacement therapy showed notable therapeutic effects. Conclusion Combined treatments including glucocorticoids, mycophenolate , rituximab and continuous renal replacement therapy can effectively cure HUS after allogeneic hemopoietic stem cell transplantation.