临床病例讨论（step by step）——自体干细胞移植后发热、呼吸困难

 植入综合征 (ES) 系造血干细胞移植过程中严重并发症，主要发生在造血干细胞移植后中性粒细胞恢复早期。ES以发热、皮疹、非心源性肺水肿为主要特征。ES以往与高移植相关死亡率相关，多数患者死于呼吸衰竭和多器官功能不全。早期诊断并合理应用皮质激素可以显著降低移植相关死亡率。本文报道了一个年轻女性NHL患者,在自体外周血干细胞移植后粒细胞恢复早期出现发热、呼吸困难、肺水肿，早期诊断为ES并及时应用皮质激素后病情获得完全缓解。

Fever and dyspnea after autologous peripheral blood stem cell transplantation

Engraftment syndrome (ES) is a severe complication that occurs during neutrophil recovery following hematopoietic stem cell transplantation. It is characterized by fever, skin rash, and non-cardiac pulmonary edema. Previously, ES was associated with a high transplant-related mortality, mostly from respiratory failure and associated multi-organ dysfunction syndrome. For ES, early diagnosis and corticosteroid therapy can dramatically decrease transplant-related mortality rate. The authors report a young female patient with Non Hodgkin Lymphoma who presented with fever, dyspnea and diffuse pulmonary infiltration at the time of neutrophil engraftment following autologous peripheral blood stem cell transplantation. She was early diagnosed as ES and recovered promptly after treatment with corticosteroid.