{"created":"2023-06-19T10:29:46.704222+00:00","id":1884,"links":{},"metadata":{"_buckets":{"deposit":"d6205430-1714-47de-bb63-32a58808d125"},"_deposit":{"created_by":31,"id":"1884","owners":[31],"pid":{"revision_id":0,"type":"depid","value":"1884"},"status":"published"},"_oai":{"id":"oai:kwmed.repo.nii.ac.jp:00001884","sets":["1709617079800:35:604:605"]},"author_link":["110485","110486","110487","110488","110489","110490","110491","110492","110493","110494","110495","110496","110497","110498","110499","110500","110501","110502","110503","110504","110505","110506"],"item_10001_biblio_info_7":{"attribute_name":"書誌情報","attribute_value_mlt":[{"bibliographicIssueDates":{"bibliographicIssueDate":"2017","bibliographicIssueDateType":"Issued"},"bibliographicIssueNumber":"1","bibliographicPageEnd":"68","bibliographicPageStart":"63","bibliographicVolumeNumber":"43","bibliographic_titles":[{"bibliographic_title":"川崎医学会誌","bibliographic_titleLang":"ja"},{"bibliographic_title":"Kawasaki medical journal","bibliographic_titleLang":"en"}]}]},"item_10001_description_33":{"attribute_name":"記事種別(日)","attribute_value_mlt":[{"subitem_description":"症例報告","subitem_description_language":"ja","subitem_description_type":"Other"}]},"item_10001_description_34":{"attribute_name":"記事種別(英)","attribute_value_mlt":[{"subitem_description":"Case Report","subitem_description_language":"en","subitem_description_type":"Other"}]},"item_10001_publisher_8":{"attribute_name":"出版者","attribute_value_mlt":[{"subitem_publisher":"川崎医学会","subitem_publisher_language":"ja"}]},"item_10001_relation_14":{"attribute_name":"DOI","attribute_value_mlt":[{"subitem_relation_type":"isIdenticalTo","subitem_relation_type_id":{"subitem_relation_type_id_text":"https://doi.org/10.11482/KMJ-J43(1)63","subitem_relation_type_select":"DOI"}}]},"item_10001_relation_17":{"attribute_name":"関連サイト","attribute_value_mlt":[{"subitem_relation_type_id":{"subitem_relation_type_id_text":"http://igakkai.kms-igakkai.com/wp/wp-content/uploads/2017/KMJ-J43(1)63.pdf","subitem_relation_type_select":"URI"}}]},"item_10001_source_id_11":{"attribute_name":"書誌レコードID","attribute_value_mlt":[{"subitem_source_identifier":"AN00045593","subitem_source_identifier_type":"NCID"},{"subitem_source_identifier":"AN12940574","subitem_source_identifier_type":"NCID"}]},"item_10001_source_id_9":{"attribute_name":"ISSN","attribute_value_mlt":[{"subitem_source_identifier":"0386-5924","subitem_source_identifier_type":"PISSN"},{"subitem_source_identifier":"2758-089X","subitem_source_identifier_type":"EISSN"}]},"item_10001_text_31":{"attribute_name":"著者所属(日)","attribute_value_mlt":[{"subitem_text_language":"ja","subitem_text_value":"川崎医科大学血液内科学"},{"subitem_text_language":"ja","subitem_text_value":"川崎医科大学病理学１"},{"subitem_text_language":"ja","subitem_text_value":"川崎医科大学血液内科学"},{"subitem_text_language":"ja","subitem_text_value":"川崎医科大学血液内科学"},{"subitem_text_language":"ja","subitem_text_value":"川崎医科大学血液内科学"},{"subitem_text_language":"ja","subitem_text_value":"川崎医科大学血液内科学"},{"subitem_text_language":"ja","subitem_text_value":"川崎医科大学血液内科学"},{"subitem_text_language":"ja","subitem_text_value":"川崎医科大学血液内科学"},{"subitem_text_language":"ja","subitem_text_value":"川崎医科大学病理学１"},{"subitem_text_language":"ja","subitem_text_value":"川崎医科大学血液内科学"},{"subitem_text_language":"ja","subitem_text_value":"川崎医科大学血液内科学"}]},"item_10001_text_32":{"attribute_name":"著者所属(英)","attribute_value_mlt":[{"subitem_text_language":"en","subitem_text_value":"Department of Hematology, Kawasaki Medical School"},{"subitem_text_language":"en","subitem_text_value":"Department of Pathology 1, Kawasaki Medical School"},{"subitem_text_language":"en","subitem_text_value":"Department of Hematology, Kawasaki Medical School"},{"subitem_text_language":"en","subitem_text_value":"Department of Hematology, Kawasaki Medical School"},{"subitem_text_language":"en","subitem_text_value":"Department of Hematology, Kawasaki Medical School"},{"subitem_text_language":"en","subitem_text_value":"Department of Hematology, Kawasaki Medical School"},{"subitem_text_language":"en","subitem_text_value":"Department of Hematology, Kawasaki Medical School"},{"subitem_text_language":"en","subitem_text_value":"Department of Hematology, Kawasaki Medical School"},{"subitem_text_language":"en","subitem_text_value":"Department of Pathology 1, Kawasaki Medical School"},{"subitem_text_language":"en","subitem_text_value":"Department of Hematology, Kawasaki Medical School"},{"subitem_text_language":"en","subitem_text_value":"Department of Hematology, Kawasaki Medical School"}]},"item_10001_textarea_5":{"attribute_name":"抄録(英)","attribute_value_mlt":[{"subitem_textarea_language":"en","subitem_textarea_value":"Post-transplant lymphoproliferative disorder (PTLD), a life-threatening condition with poor prognosis, can arise after allogeneic hematopoietic stem cell transplantation. The clinical symptoms are non-specific, but if PTLD is suspected, the blood levels of Epstein-Barr (EB) virus DNA are measured using PCR. Here, we report our experience with a patient who showed high levels of EB virus DNA in the blood and a rapidly worsening condition resulting in death, after undergoing hematopoietic stem cell transplantation. The patient was male and in his 40s; he had developed Philadelphia chromosome-positive acute lymphoid leukemia and achieved remission with treatment, and he later underwent umbilical cord blood transplantation. A high fever appeared 280 days after transplantation, and he was hospitalized and diagnosed with bacterial pneumonia following a thoracic CT examination. He was initiated on antimicrobial therapy, but responded poorly, exhibiting a worsening respiratory condition and disturbance of consciousness. Abnormally high EB virus DNA levels were detected in his blood, bronchoalveolar lavage fluid, and cerebrospinal fluid. He was diagnosed with PTLD, but his respiratory condition deteriorated rapidly and he died. The autopsy revealed alveolar hemorrhage, which was thought to be the cause of the rapid deterioration. A large number of EBER (EBV-encoded small RNA)- positive cells were also found in hilar lymph nodes and lungs, which were deemed to be early lesions of PTLD. Therefore, timely action is crucial if lesions are presents as even early PTLD lesions can progress rapidly owing to bleeding that can result in the deterioration of the respiratory condition."}]},"item_10001_textarea_6":{"attribute_name":"抄録(日)","attribute_value_mlt":[{"subitem_textarea_language":"ja","subitem_textarea_value":"移植後リンパ増殖性疾患（post-transplant lymphoproliferative disorders, PTLD）は，同種造血幹細胞移植後の生命を脅かす予後不良な合併症の一つである．臨床症状は非特異的であるが，PTLD を疑った場合はPCR 法による血中EB（Epstein-Barr）ウイルス-DNA 量を測定し，高値を示した場合はPTLD と判断する必要がある．今回，造血幹細胞移植後に高EB ウイルス血症を認め，急激な病状の悪化により死亡した症例を経験したため剖検所見を含め報告する．症例は，40歳代男性でフィラデルフィア染色体陽性急性リンパ性白血病を発症し，治療にて寛解を得た後に臍帯血移植を施行した．移植後280日に高熱が出現し，胸部CT 検査から細菌性肺炎と診断し入院．抗菌薬治療を開始するも効果不良であり，呼吸状態の悪化と，意識障害が出現した．血液，肺胞洗浄液と髄液から，EB ウイルス-DNA 異常高値が検出された．PTLD と判断したが，急激に呼吸状態が悪化し死亡した．剖検では，肺胞内出血を認め，急激に悪化した原因と考えられた．そして，肺門部リンパ節や肺にはEBER（EBV-encoded small RNA）陽性細胞を多数認め，一部では大型多核細胞も散見され，early lesion of PTLD と判断された．Early lesion of PTLD であっても，本症例のように肺病変を認めた場合，出血による呼吸状態の悪化から急激な経過をたどることがあり，早期の対応が必要と考えられた． "}]},"item_10001_version_type_20":{"attribute_name":"著者版フラグ","attribute_value_mlt":[{"subitem_version_resource":"http://purl.org/coar/version/c_970fb48d4fbd8a85","subitem_version_type":"VoR"}]},"item_creator":{"attribute_name":"著者","attribute_type":"creator","attribute_value_mlt":[{"creatorNames":[{"creatorName":"佐野, 史典","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"西村, 広健","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"徳永, 博俊","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"近藤, 敏範","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"松橋, 佳子","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"中西, 秀和","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"清水, 里紗","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"山田, 聖子","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"定平, 吉都","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"和田, 秀穂","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"杉原, 尚","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"SANO, Fuminori","creatorNameLang":"en"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"NISHIMURA, Hirotake","creatorNameLang":"en"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"TOKUNAGA, Hirotoshi","creatorNameLang":"en"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"KONDO, Toshinori","creatorNameLang":"en"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"MATSUHASHI, Yoshiko","creatorNameLang":"en"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"NAKANISHI, Hidekazu","creatorNameLang":"en"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"SHIMIZU, Risa","creatorNameLang":"en"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"YAMADA, Seiko","creatorNameLang":"en"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"SADAHIRA, Yoshito","creatorNameLang":"en"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"WADA, Hideho","creatorNameLang":"en"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"SUGIHARA, Takashi","creatorNameLang":"en"}],"nameIdentifiers":[{}]}]},"item_files":{"attribute_name":"ファイル情報","attribute_type":"file","attribute_value_mlt":[{"accessrole":"open_date","date":[{"dateType":"Available","dateValue":"2017-09-28"}],"displaytype":"detail","filename":"KMJ-J43(1)63.pdf","filesize":[{"value":"1.2 MB"}],"format":"application/pdf","licensetype":"license_note","mimetype":"application/pdf","url":{"label":"PDF","objectType":"fulltext","url":"https://kwmed.repo.nii.ac.jp/record/1884/files/KMJ-J43(1)63.pdf"},"version_id":"12028be9-06bb-4feb-bbb3-9521c6f5ae6a"}]},"item_keyword":{"attribute_name":"キーワード","attribute_value_mlt":[{"subitem_subject":"移植後リンパ増殖性疾患","subitem_subject_language":"ja","subitem_subject_scheme":"Other"},{"subitem_subject":"EB ウイルス","subitem_subject_language":"ja","subitem_subject_scheme":"Other"},{"subitem_subject":"臍帯血移植","subitem_subject_language":"ja","subitem_subject_scheme":"Other"},{"subitem_subject":"Post-transplant lymphoproliferative disorders","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"Ebvirus","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"Umbilical cord blood transplant","subitem_subject_language":"en","subitem_subject_scheme":"Other"}]},"item_language":{"attribute_name":"言語","attribute_value_mlt":[{"subitem_language":"jpn"}]},"item_resource_type":{"attribute_name":"資源タイプ","attribute_value_mlt":[{"resourcetype":"journal article","resourceuri":"http://purl.org/coar/resource_type/c_6501"}]},"item_title":"臍帯血移植後発症した early lesion of PTLD の剖検例","item_titles":{"attribute_name":"タイトル","attribute_value_mlt":[{"subitem_title":"臍帯血移植後発症した early lesion of PTLD の剖検例","subitem_title_language":"ja"},{"subitem_title":"Autopsy case of early lesion of PTLD after umbilical cord blood transplantation","subitem_title_language":"en"}]},"item_type_id":"10001","owner":"31","path":["605"],"pubdate":{"attribute_name":"PubDate","attribute_value":"2017-09-28"},"publish_date":"2017-09-28","publish_status":"0","recid":"1884","relation_version_is_last":true,"title":["臍帯血移植後発症した early lesion of PTLD の剖検例"],"weko_creator_id":"31","weko_shared_id":-1},"updated":"2024-04-15T07:26:05.464671+00:00"}