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M9460563.TXT
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1994-06-25
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Document 0563
DOCN M9460563
TI Disseminated Mycobacterium avium-intracellulare infection in a patient
with myelodysplastic syndrome (refractory anemia).
DT 9408
AU Tsukada H; Chou T; Ishizuka Y; Ogawa O; Saeki T; Ito S; Wakabayashi M;
Hayashi N; Arakawa M; Department of Medicine (II), Niigata University
Medical School,; Japan.
SO Am J Hematol. 1994 Apr;45(4):325-9. Unique Identifier : AIDSLINE
MED/94234124
AB A 31-year-old woman presented with fever and arthralgia. Despite
treatment with antimicrobials and corticosteroids, her symptoms
persisted. A diagnosis of myelodysplastic syndrome (MDS)-refractory
anemia (RA) was made by pancytopenia, dysplasia, and trisomy 8. Cultures
of bone marrow, blood, and gastric juice showed Mycobacterium
avium-intracellulare (MAI). She was treated with antimycobacterial drugs
and recombinant human G-CSF/M-CSF and showed an initial response, but
spike fever recurred and pancytopenia progressed. Hepatosplenomegaly and
marked retroperitoneal lymphadenopathy were revealed, indicating further
dissemination of MAI. Treatment with recombinant human GM-CSF and
very-low-dose cytosine arabinoside, was started but was not effective.
This case showed significant reduction in peripheral blood
T-lymphocytes, especially the CD4+ population, and low immunoglobulin
levels. Immunodeficiency state associated with long-term steroid therapy
and MDS seemed to contribute to the development of the disseminated
infection with MAI.
DE Adult Anemia, Refractory/*COMPLICATIONS/DRUG THERAPY/MICROBIOLOGY
Antigens, CD4/ANALYSIS AIDS-Related Opportunistic Infections/IMMUNOLOGY
Bone Marrow/MICROBIOLOGY Case Report Cytarabine/THERAPEUTIC USE
Dose-Response Relationship, Drug Female Gastric Juice/MICROBIOLOGY
Granulocyte-Macrophage Colony-Stimulating Factor/BLOOD/ THERAPEUTIC USE
Human Macrophage Colony-Stimulating Factor/THERAPEUTIC USE
Mycobacterium avium-intracellulare Infection/*COMPLICATIONS/DRUG
THERAPY/IMMUNOLOGY Myelodysplastic Syndromes/*COMPLICATIONS/DRUG
THERAPY/ MICROBIOLOGY Recombinant Proteins/THERAPEUTIC USE
T-Lymphocytes/IMMUNOLOGY/PATHOLOGY Time Factors JOURNAL ARTICLE
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).