RESUMEN
A 10-year old girl diagnosed as severe aplastic anemia was transplanted with peripheral stem cells from a CMV seropositive full matched unrelated donor. The conditioning regimen consisted of busulfan, fludarabine, and anti-thymocyte globulin (ATG). At D+114, abdominal pain, fever, and blood-tinged watery diarrhea developed. At D+116, pneumatosis intestinalis (PI) was detected on simple abdominal X-ray and computed tomography (CT). Ganciclovir was started intravenously because CMV antigenemia was detected at D+117. Two days later, PI sign disappeared on simple abdominal X-ray, and hematochezia began to decrease. CMV antigenemia disappeared 10 days after starting ganciclovir. We describe a 10-year old girl with severe aplastic anemia who developed PI in the presence of CMV infection and gastro-intestinal graft-versus-host-disease (GVHD) after allogeneic stem cell transplantation and was treated successfully with ganciclovir.
Asunto(s)
Femenino , Humanos , Dolor Abdominal , Anemia Aplásica , Suero Antilinfocítico , Busulfano , Diarrea , Fiebre , Ganciclovir , Hemorragia Gastrointestinal , Enfermedad Injerto contra Huésped , Trasplante de Células Madre Hematopoyéticas , Células Madre Hematopoyéticas , Trasplante de Células Madre , Células Madre , Donante no Emparentado , VidarabinaRESUMEN
PURPOSE: To describe the prevalence and severity of postneonatal epilepsy after neonatal seizures in term neonates as well as to evaluate the predictive factors of postneonatal epilepsy. METHODS: Retrospective analysis of 50 children who experienced neonatal seizures. In children with at least 12 months of follow-up data, the univariate and multivariate logistic regression analysis was applied in order to determine the predictive factors of postneonatal epilepsy. Electroencephalography (EEG), neuroimaging studies, and other clinical variables were systematically analyzed. Infants with abnormal EEG recordings in the initial studies underwent a follow-up EEG examination at 1 or 3 months later. RESULTS: Twelve of 50 neonates with neonatal seizures (24%) developed postneonatal epilepsy. Seventy-five percent (9 of 12) of the children with postneonatal epilepsy were eventually seizure-free without AED (antiepileptic drug), and 25% (3 of 12) had seizures at the last follow-up (modified angel classification 2 or 3, mean follow-up period; 52 months). On the univariate logistic regression analysis, abnormal EEG, Magnetic resonance imaging (MRI) findings, combined with encephalopathy and the number of AEDs were correlated with postneonatal epilepsy (P<0.05). On the multivariate analysis, the persistent abnormality on the follow-up EEG was correlated with postneonatal epilepsy (adjusted odds ratio=20.78; P=0.016). CONCLUSION: The number of intractable cases was relatively low, indicating good prognosis in postneonatal epilepsy. Abnormal EEG, MRI findings, combined with encephalopathy, and the number of AEDs were very good predictors of postneonatal epilepsy. The persistent abnormality in the follow-up EEG was more frequently seen in postneonatal epilepsy patients.
Asunto(s)
Niño , Humanos , Lactante , Recién Nacido , Clasificación , Electroencefalografía , Epilepsia , Estudios de Seguimiento , Modelos Logísticos , Imagen por Resonancia Magnética , Análisis Multivariante , Neuroimagen , Prevalencia , Pronóstico , Estudios Retrospectivos , ConvulsionesRESUMEN
A 10-year old girl diagnosed as severe aplastic anemia was transplanted with peripheral stem cells from a CMV seropositive full matched unrelated donor. The conditioning regimen consisted of busulfan, fludarabine, and anti-thymocyte globulin (ATG). At D+114, abdominal pain, fever, and blood-tinged watery diarrhea developed. At D+116, pneumatosis intestinalis (PI) was detected on simple abdominal X-ray and computed tomography (CT). Ganciclovir was started intravenously because CMV antigenemia was detected at D+117. Two days later, PI sign disappeared on simple abdominal X-ray, and hematochezia began to decrease. CMV antigenemia disappeared 10 days after starting ganciclovir. We describe a 10-year old girl with severe aplastic anemia who developed PI in the presence of CMV infection and gastro-intestinal graft-versus-host-disease (GVHD) after allogeneic stem cell transplantation and was treated successfully with ganciclovir.
Asunto(s)
Femenino , Humanos , Dolor Abdominal , Anemia Aplásica , Suero Antilinfocítico , Busulfano , Diarrea , Fiebre , Ganciclovir , Hemorragia Gastrointestinal , Enfermedad Injerto contra Huésped , Trasplante de Células Madre Hematopoyéticas , Células Madre Hematopoyéticas , Trasplante de Células Madre , Células Madre , Donante no Emparentado , VidarabinaRESUMEN
A 10-year old girl diagnosed as severe aplastic anemia was transplanted with peripheral stem cells from a CMV seropositive full matched unrelated donor. The conditioning regimen consisted of busulfan, fludarabine, and anti-thymocyte globulin (ATG). At D+114, abdominal pain, fever, and blood-tinged watery diarrhea developed. At D+116, pneumatosis intestinalis (PI) was detected on simple abdominal X-ray and computed tomography (CT). Ganciclovir was started intravenously because CMV antigenemia was detected at D+117. Two days later, PI sign disappeared on simple abdominal X-ray, and hematochezia began to decrease. CMV antigenemia disappeared 10 days after starting ganciclovir. We describe a 10-year old girl with severe aplastic anemia who developed PI in the presence of CMV infection and gastro-intestinal graft-versus-host-disease (GVHD) after allogeneic stem cell transplantation and was treated successfully with ganciclovir.