一例C型慢性肝炎病例,患者在结肠干扰素-利巴韦林联合治疗期间,出现脾摘后激性感染(OPSI)。

修祐 岡村, 輝文 酒井, 浩史 吉貝, 博明 住江, 成田 高三郎, 卓 辛島, 泰彦 前山, 浩一 檜垣, 達也 井出, 通夫 佐田
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引用次数: 4

摘要

例61岁女性,既往脾切除术,因干扰素治疗慢性丙型肝炎时出现高热、意识丧失,入院后不久因多器官功能衰竭死亡,并发弥散性血管内凝血。血液培养和尸检结果显示是肺炎链球菌引起的败血症。中性粒细胞减少和干扰素治疗的免疫抑制诱导压倒性脾切除术后感染(OPSI),一种潜在的迅速致命的败血症。当我们对脾切除术患者进行免疫抑制治疗,如干扰素治疗或抗癌药物治疗时,有必要进行肺炎球菌疫苗接种。慢性丙型肝炎伴血小板减少患者在干扰素治疗前行脾切除术。为了避免OPSI,我们讨论了部分脾动脉栓塞。
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ペグインターフェロン·リバビリン併用療法中に脾摘後劇症型感染症(OPSI)を発症したC型慢性肝炎の1例
: A 61-year-old woman with a past history of splenectomy was admitted to our hospital because of high fever and loss of consciousness during interferon therapy for the treatment of chronic hepatitis type C. She died of multiple organ failure, and disseminated intravascular coagulation shortly after admission. The results of blood culture and the autopsy revealed sepsis due to streptcoccus pneumonia. The neutropenia and immunosuppression by interferon therapy induced overwhelming postsplenectomy infection (OPSI), a potentially rapidly fatal septicemia. When we perform treatment with immunosuppression such as interferon therapy or anticancer drug therapy to splenectomised patients, it is necessary to carry out pnemococcus vaccination. Splenectomy is performed for patients with thrombocytopenia of chronic hepatitis type C before interferon therapy. To avoid OPSI, partial splenic arterial embolization was discussed.
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