【常见可变免疫缺陷患者非肝硬化门脉高压的临床特点】。

J Wu, X X Han, H Di, Y Yin, Y D Han, Y Wang, Y Zhang, X J Zeng
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引用次数: 0

摘要

我们希望总结共同可变免疫缺陷(CVID)合并非肝硬化门静脉高压症(NCPH)的临床特点,加深我们对它的认识。回顾性分析1983年1月至2021年5月北京协和医院收治的CVID合并NCPH病例资料,总结其临床特点。CVID合并NCPH 6例(男女各3例;16-45岁)进行评估。4例患者有门静脉高压症。所有患者均有贫血、脾肿大,血清白蛋白和转氨酶水平正常,碱性磷酸酶和γ -谷氨酰转肽酶水平可能升高。2例患者经胃镜检查诊断为食管胃底静脉曲张。2例患者行脾切除术(部分改善血液学异常)。4名患者患有自身免疫性疾病。2例经肝活检诊断为结节性再生增生(NRH)。6例患者静脉注射免疫球蛋白g (0.4-0.6 g/kg体重)作为基础治疗,每3-4周1次。CVID合并NCPH通常有:(1)以门静脉高压症为主要症状。(2)自身免疫相关表现。影像可以提供重要的诊断线索。病因可能与复发性感染引起的肝脏NRH和脾肿大有关。
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[Clinical features of non-cirrhotic portal hypertension in patients with common variable immunodeficiency].

We wished to summarize the clinical features of common variable immunodeficiency (CVID) complicated by non-cirrhotic portal hypertension (NCPH) and to deepen our understanding of it. The case data of CVID complicated with NCPH admitted to Peking Union Medical College Hospital from January 1983 to May 2021 were analyzed retrospectively to summarize their clinical characteristics. Six patients with CVID combined with NCPH (three of each sex; 16-45 years) were assessed. Four patients had portal hypertension. All patients had anemia, splenomegaly, a normal serum level of albumin and transaminases, and possibly increased levels of alkaline phosphatase and gamma-glutamyl transpeptidase. Two patients were diagnosed with esophagogastric fundic varices by gastroscopy. Two patients underwent splenectomy (which improved hematologic abnormalities partially). Four patients had autoimmune disease. Two cases were diagnosed with nodular regenerative hyperplasia (NRH) upon liver biopsy. Six patients were administered intravenous immunoglobulin-G (0.4-0.6 g/kg bodyweight) once every 3-4 weeks as basic therapy. Often, CVID complicated with NCPH has: (1) The manifestations of portal hypertension as the primary symptom. (2) Autoimmune-related manifestations. Imaging can provide important diagnostic clues. The etiology may be related to hepatic NRH and splenomegaly due to recurrent infections.

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