吉林大学学报(医学版) ›› 2023, Vol. 49 ›› Issue (1): 187-192.doi: 10.13481/j.1671-587X.20230124

• 临床医学 • 上一篇    

非霍奇金淋巴瘤并发人类冠状病毒HKU1肺炎1例报告及文献复习

吴文玉1,2,刘城鑫1,王凯2,吴鹏1,詹少锋1,2(),刘小虹2   

  1. 1.广州中医药大学第一临床医学院中医内科,广东 广州 510405
    2.广州中医药大学第一附属医院呼吸与危重症医学科,广东 广州 510405
  • 收稿日期:2022-04-30 出版日期:2023-01-28 发布日期:2023-02-03
  • 通讯作者: 詹少锋 E-mail:zsfstone@126.com
  • 作者简介:吴文玉(1996-),男,广东省韶关市人,住院医师,医学硕士,主要从事呼吸系统疾病临床方面的研究。
  • 基金资助:
    国家自然科学基金项目(81973814);广东省教育厅研究生教育创新计划项目(2022ANLK025);广东省中医药局中医药科研项目(20231169)

Non-Hodgkin’s lymphoma complicated with human coronavirus HKU1 pneumonia:A case report and literature review

Wenyu WU1,2,Chengxin LIU1,Kai WANG2,Peng WU1,Shaofeng ZHAN1,2(),Xiaohong LIU2   

  1. 1.Department of Traditional Chinese Medicine,College of First Clinical Medical Sciences,Guangzhou University of Traditional Chinese Medicine,Guangzhou 510405,China
    2.Department of Respiratory and Critical Care Medicine,First Affiliated Hospital,Guangzhou University of Traditional Chinese Medicine,Guangzhou 510405,China
  • Received:2022-04-30 Online:2023-01-28 Published:2023-02-03
  • Contact: Shaofeng ZHAN E-mail:zsfstone@126.com

摘要:

目的 分析非霍奇金淋巴瘤并发人类冠状病毒(HCoV)-HKU1肺炎患者的临床表现、诊断方法和治疗过程,以提高临床医务人员对于该病的认识,减少临床不良事件的发生。 方法 分析2021年1月于本院住院的1例以夜间潮热盗汗、干咳和咽干为主要临床表现的非霍奇金淋巴瘤并发HCoV-HKU1肺炎患者的临床资料,并对既往相关研究文献进行复习,分析其临床表现和诊断经过。 结果 患者,女性,因确诊非霍奇金淋巴瘤2月余入院。查体,卡氏评分90分,全身浅表淋巴结未扪及肿大,右下腹部轻压痛,无反跳痛,双肺呼吸音稍粗,双下肺可闻及少许湿啰音。胸部CT显示双肺弥漫性渗出灶,尿液分析中白细胞数158 μL-1,采用第二代基因测序技术(NGS)检测肺泡灌洗液明确诊断为HCoV-HKU1肺炎。患者入院时有右下腹隐痛、夜间咳嗽和盗汗等症状,予奥司他韦抗病毒治疗无效,予复方磺胺甲恶唑片联合连花清瘟颗粒治疗后呼吸道症状消失,复查胸部CT提示渗出灶已吸收。 结论 非霍奇金淋巴瘤并发HCoV-HKU1肺炎患者临床症状无特异性,临床出现肺部弥漫性阴影改变而新型冠状病毒核酸检测阴性时,仍需重视其他HCoV感染的可能。通过NGS可以高效筛选感染病原体,有利于更加精准地指导肺部感染性疾病的诊断和治疗。

关键词: 人类冠状病毒HKU1, 非霍奇金淋巴瘤, 第二代测序技术, 肺泡灌洗液

Abstract:

Objective To analyze the clinical manifestations, diagnostic methods and treatment process of the patients with non-Hodgkin’s lymphoma complicated with human coronavirus(HCoV)-HKU1 pneumonia and improve the clinical medical staff’s awareness of the disease, and to reduce the occurrence of clinical adverse events. Methods The clinical data of a patient with non-Hodgkin’s lymphoma complicated with HCoV-HKU1 pneumonia with hot flashes and night sweats, dry cough and dry throat as the main clinical features who were hospitalized in the hospital in January 2021 were analyzed, and the relevant literatures were reviewed and the clinical manifestations and diagnosis of HCoV-HKU1 were analyzed. Results The female patient was admitted to the hospital due to diagnosed non-Hodgkin’s lymphoma for more than 2 months. The physical examination results showed Karnofsky score was 90 points; there was no palpable enlargement of systemic superfical lymph nodes; mild tenderness in the right lower abdomen, no rebound tenderness,and slightly thicker breath sounds in both lungs were found, and a few moist rales were heard in both lower lungs. The chest CT results showed diffuse exudative foci in both lungs,and the number of white blood cells in the urine analysis was 158 μL-1; next generation sequencing technique(NGS) was used the detect the bronchoalveolar lavage fluid,and HCoV-HKU1 pneumonia was diagnosed. At admission, the patient had symptoms such as dull pain in the right lower abdomen, nighttime cough, and night sweats; antiviral treatment with oseltamivir was ineffective. After treatment with Compound Sulfamethoxazole Tablets and Lianhua Qingwen Granules, the respiratory symptoms of the patient disappeared. The re-examination chest CT results showed the exudation was absorbed. Conclusion The clinical symptoms of the patients with non-Hodgkin’s lymphoma complicated with HCoV-HKU1 pneumonia are non-specific. When the diffuse shadow changes in the lungs are found in clinic, and the new coronavirus nucleic acid test is negative, attention should still be paid to the possibility of other HCoV infections. The NGS can efficiently screen the infectious pathogens, which is beneficial to guide the diagnosis and treatment of pulmonary infectious diseases more accurately.

Key words: Human coronavirus HKU1, Non-Hodgkin’s lymphoma, Next generation sequencing, Bronchoalveolar lavage fluid

中图分类号: 

  • R733.4