Yamaguchi medical journal

Yamaguchi University medical association

PISSN : 0513-1731
NCID : AN00243156

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Yamaguchi medical journal Volume 71 Issue 2-3
published_at 2022-08-31

Acquired Immunodeficiency Syndrome with a Clinical Presentation of Cytomegalovirus Infection following Chemotherapy for Malignant Lymphoma

悪性リンパ腫に対する化学療法後に発症したcytomegalovirus感染症を契機に判明した後天性免疫不全症候群
Hamada Risako
Konaka Kiminori
Nakayama Ayana
Matsumura Takuro
Tominaga Takayuki
Takahashi Toru
fulltext
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B030071000204 .pdf
A 69-year-old deaf-mute man received 6 cycles of R-CHOP therapy for diffuse large B-cell lymphoma(DLBCL)of the stomach. Although he showed a complete response to this therapeutic regimen, the patient developed intractable diarrhea upon completion of chemotherapy. He was diagnosed with cytomegalovirus(CMV)enteritis and was administered ganciclovir and foscarnet;however, CMV infection persisted. We suspected immunodeficiency other than that associated with chemotherapy-induced immunosuppression. Further examinations revealed a decrease in the CD4^+ T lymphocyte count and positive results on anti-human immunodeficiency virus(HIV)antibody testing, which confirmed HIV infection, and he was diagnosed with acquired immunodeficiency syndrome(AIDS).Antiviral therapy was initiated, and the HIV-RNA viral load became undetectable;however, the CD4^+ T lymphocyte count recovery was insufficient. Despite the clinical presentation of an AIDS-indicator disease, diagnosis of HIV infection was delayed, which may be attributable to deaf-mutism and the patient’s advanced age that may have led to bias among the medical staff and prevented prompt diagnosis of HIV infection.
Creator Keywords
後天性免疫不全症候群
HIV感染症
びまん性大細胞型B細胞リンパ腫
サイトメガロウイルス感染症