Défaillance multiviscérale et infection disséminée à adénovirus |
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Authors: | C Bretonnière C Touzeau T Guillaume M Coste-Burel A Moreau M Hamidou C Guitton D Villers |
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Institution: | 1. Service de réanimation médicale polyvalente, CHU de Nantes, immeuble Jean-Monnet, 1, place Alexis-Ricordeau, 44035 Nantes, France;2. Faculté de médecine, 1, rue Gaston-Veil, 44035 Nantes cedex 1, France;3. Service d’hématologie clinique, Hôtel-Dieu, CHU de Nantes, 1, place Alexis-Ricordeau, 44035 Nantes, France;4. Service de virologie, Hôtel-Dieu, CHU de Nantes, 1, place Alexis-Ricordeau, 44035 Nantes, France;5. Service d’anatomopathologie, CHU de Nantes, immeuble Jean-Monnet, 1, place Alexis-Ricordeau, 44035 Nantes, France;6. Service de médecine interne, Hôtel-Dieu, CHU de Nantes, 1, place Alexis-Ricordeau, 44035 Nantes, France |
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Abstract: | BackgroundPeripheral blood stem cell transplantation is a frequent option, especially for patients with hematological malignancies.Case reportsA first patient received this treatment for acute myeloblastic leukemia, the second for Richter's syndrome (follicular lymphoma). In both cases, allograft (unrelated donor, non myeloablative conditioning) was followed by graft versus host disease (GVH) requiring an immunosuppressive treatment. Respectively 15 and three months after graft, these two patients presented with multiple organ failure including very severe hepatic dysfunction. The diagnosis was made according to positive blood PCR, positive BAL, and hepatic histological findings.DiscussionAdenoviruses, frequent in pediatrics, can be responsible for extremely severe infections among immunocompromised adults. T lymphocyte depletion plays a key role.ConclusionAdenoviral infections can be fatal among immunocompromised patients. Diagnostic improvement should lead to early treatment, which however, remains to be clearly defined. |
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Keywords: | Adé novirus Dé faillance multiviscé rale Immunodé primé Greffe de cellules souches pé riphé riques |
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