一例传染性单核细胞增多症伴胆囊炎报告
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摘要
传染性单核细胞增多症(infectious monocytosis)是系统急性增生性传染病,病毒进入口腔,在咽部淋巴组织复制,进而进入血流产生病毒血症,主要累及全身淋巴组织与内脏,咽部上皮、B细胞、T细胞、NK细胞均具有EB病毒受体CD21,但是传单主要感染B细胞,继而引起T细胞强烈反应,形成可见的异常淋巴细胞,即活化的抑制性T细胞(CD8+HLA-D+,CD8+CD45RO+)。所以本病病理组织学改变为淋巴细胞的良性增生,并不化脓,肝、脾、心肌、肾、肾上腺、肺、中枢神经均受累,表现为异常淋巴细胞浸润。但引起胆囊炎改变不多见。本文报道一例传染性单核细胞增多症伴有胆囊炎患者,EB病毒感染导致患者机体免疫紊乱,进而可以伴发胆囊炎等并发症。
Infectious mononucleosis is a systematic acute proliferative infectious disease, after entering mouth, virus replicates at pharynx lymphoid tissue, and entering blood flow inducing viremia, infecting systemic lymphoid tissue and viscus, pharynx epithelium, B cells, T cells and NK cells with EB virus receptor CD21. But infectious mononucleosis mainly infects B cells, causing strong reaction of T cells, formating visible abnormal lymphocytes, namely active inhibitory T cells(CD8+HLA-D+, CD8+CD45 RO+). Therefore, histopathological changes of the disease are benign proliferation of lymphocytes, not pyogenic, and liver, spleen, myocardium, kidney, adrenal gland, lung and central nervous system is involved, with syptoms of abnormal lymphocyte infiltration. However, cholecystitis changes were not common. The article reported a case infectious mononucleosis and cholecystitis, patient's body immune disorder caused by EB virus infection, with complications of cholecystitis and etc.
Infectious mononucleosis is a systematic acute proliferative infectious disease, after entering mouth, virus replicates at pharynx lymphoid tissue, and entering blood flow inducing viremia, infecting systemic lymphoid tissue and viscus, pharynx epithelium, B cells, T cells and NK cells with EB virus receptor CD21. But infectious mononucleosis mainly infects B cells, causing strong reaction of T cells, formating visible abnormal lymphocytes, namely active inhibitory T cells(CD8+HLA-D+, CD8+CD45 RO+). Therefore, histopathological changes of the disease are benign proliferation of lymphocytes, not pyogenic, and liver, spleen, myocardium, kidney, adrenal gland, lung and central nervous system is involved, with syptoms of abnormal lymphocyte infiltration. However, cholecystitis changes were not common. The article reported a case infectious mononucleosis and cholecystitis, patient's body immune disorder caused by EB virus infection, with complications of cholecystitis and etc.
引文
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[2]王群,谢正德.儿童EB病毒相关疾病的诊断标准和治疗原则[J].实用儿科临床杂志,2010,25(10):706-708.
[3]Yamashita N,Kimura H,Morishima T.Virological aspects o f Epstein-Barrvirus infections[J].Acta Med Okayama,2005,59(6):239-246.
[4]Precopio LM,Sullivan JL,Willard C,et a1.Differential kinetics and specificity of EBV—specilic CIM+and CD8+T cells during primary infection[J].Immunology,2003,170(10):2590-2598.
[5]许俐,林书祥,胡坚,等.急性和慢性EB病毒感染儿童外周血CD8~+T细胞活化差异比较[J].天津医药,2010,38(07):630-631.
[6]蒋娟,于洁,王晓莉,等.伴有多脏器功能损害的传染性单核细胞增多症51例临床分析[J].中国实用儿科杂志,2007,22(12):919-922.
[7]Okano M,Kawa K,Kimura H,et al.Proposed guidelines for diagnosing chronic active epstein-barr virus infection[J].Am JHematol,2005,(80):64-69.
[8]唐云章,张银美.儿童EB病毒感染相关重症疾病的临床分析[J].重庆医学,2015,44(3):387-389.