第507例——溶血性贫血、细小病毒B19感染、多器官功能障碍

The 507th case: hemolytic anemia, parvovirus B19, and multiple organ dysfunction

患者男性,19岁,高危急性B淋巴细胞白血病行单倍体异基因造血干细胞移植,移植后多次出现贫血,检测血细小病毒B19核酸阳性,随后出现冷凝集素综合征、多器官功能障碍(呼吸衰竭、肝脏损害等)。在病毒感染和冷凝集素综合征治疗矛盾情况下充分给予支持治疗、应用补体抑制剂控制溶血、坚持抗病毒治疗,适时加用糖皮质激素及免疫抑制剂,最终获得了较好的治疗效果。

A 19-year-old male patient with high-risk acute B-cell lymphoblastic leukemia received haploidentical stem cell transplantation.He developed anemia repeatedly and parvovirus B19 nucleic acid was positive in blood plasma.The patient was diagnosed with cold agglutinin syndrome and multiple organ dysfunction including respiratory failure and hepatitis.In the conflict between viral infection and the treatment of cold agglutinin syndrome,we provided supportive treatment,complement inhibitors to control hemolysis,and antiviral therapy.After timely glucocorticoid and immunosuppressant therapy,the patient had achieved a good response.