{"title":"Primary Adrenal Insufficiency Triggered by Cytomegalovirus Infection after Obinutuzumab Plus Bendamustine Therapy for Follicular Lymphoma.","authors":"Takashi Nakamura, Hideki Uryu, Ryutaro Kawashima, Mizuki Ishiguro, Mika Tanizawa, Yasushi Kanazawa, Hiroyuki Yamazaki, Yuichi Yahagi","doi":"10.2169/internalmedicine.3334-23","DOIUrl":null,"url":null,"abstract":"<p><p>A 69-year-old man was diagnosed with follicular lymphoma (grade 3A). Obinutuzumab combined with bendamustine (OB) therapy was initiated as salvage chemotherapy. Nausea, abdominal pain, and hyponatremia appeared after six courses of OB therapy; cytomegalovirus (CMV) enteritis with primary adrenal insufficiency (PAI) was a complication. Ganciclovir and hydrocortisone were administered, and the clinical findings improved. PAI caused by CMV infection has mainly been reported in patients with acquired immunodeficiency syndrome. In the present case, the PAI triggered by CMV infection led to immunodeficiency after chemotherapy.</p>","PeriodicalId":13719,"journal":{"name":"Internal Medicine","volume":" ","pages":"273-279"},"PeriodicalIF":1.0000,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Internal Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.2169/internalmedicine.3334-23","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/5/30 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
引用次数: 0
Abstract
A 69-year-old man was diagnosed with follicular lymphoma (grade 3A). Obinutuzumab combined with bendamustine (OB) therapy was initiated as salvage chemotherapy. Nausea, abdominal pain, and hyponatremia appeared after six courses of OB therapy; cytomegalovirus (CMV) enteritis with primary adrenal insufficiency (PAI) was a complication. Ganciclovir and hydrocortisone were administered, and the clinical findings improved. PAI caused by CMV infection has mainly been reported in patients with acquired immunodeficiency syndrome. In the present case, the PAI triggered by CMV infection led to immunodeficiency after chemotherapy.
一名 69 岁的男性被诊断患有滤泡性淋巴瘤(3A 级)。作为挽救性化疗,他接受了奥比妥珠单抗联合苯达莫司汀(OB)治疗。OB治疗6个疗程后出现恶心、腹痛和低钠血症;巨细胞病毒(CMV)肠炎并发原发性肾上腺功能不全(PAI)。使用更昔洛韦和氢化可的松后,临床症状有所改善。CMV 感染引起的 PAI 主要见于获得性免疫缺陷综合征患者。在本病例中,CMV 感染引发的 PAI 导致了化疗后的免疫缺陷。
期刊介绍:
Internal Medicine is an open-access online only journal published monthly by the Japanese Society of Internal Medicine.
Articles must be prepared in accordance with "The Uniform Requirements for Manuscripts Submitted to Biomedical Journals (see Annals of Internal Medicine 108: 258-265, 1988), must be contributed solely to the Internal Medicine, and become the property of the Japanese Society of Internal Medicine. Statements contained therein are the responsibility of the author(s). The Society reserves copyright and renewal on all published material and such material may not be reproduced in any form without the written permission of the Society.