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International Journal of Hematology

, Volume 84, Issue 5, pp 438–440 | Cite as

Pancreatic Hyperamylasemia and Hyperlipasemia in Association with Cytomegalovirus Infection Following Unrelated Cord Blood Transplantation for Acute Myelogenous Leukemia

  • Akira Tomonari
  • Satoshi Takahashi
  • Kashiya Takasugi
  • Jun Ooi
  • Nobuhiro Tsukada
  • Takaaki Konuma
  • Tohru Iseki
  • Arinobu Tojo
  • Shigetaka Asano
Case report

Abstract

Cytomegalovirus (CMV)-associated pancreatitis is rare after allogeneic hematopoietic stem cell transplantation (SCT). We describe a patient who developed pancreatic hyperamylasemia and hyperlipasemia in association with CMV infection after cord blood transplantation (CBT). A 31-year-old man with acute myelogenous leukemia underwent CBT. A neutrophil count consistently greater than 500/μL was achieved on day +21. Positive results for CMV antigenemia on days +35 and +67 prompted 2 courses of preemptive therapy with ganciclovir or foscarnet. The CMV antigenemia value again became positive on day +134. On day +141, serum amylase and lipase activities markedly increased to 1221 IU/L and 894 IU/L, respectively. The patient had no abdominal symptoms. Ultrasonography and computed tomography results showed no abnormalities of the pancreas.A diagnosis of possible pancreatitis was made. After the initiation of foscarnet therapy, the CMV antigenemia results soon became negative, and serum amylase and lipase activities returned to normal. Therefore, CMV infection was considered to play a major role in the development of pancreatic hyperamylasemia and hyperlipasemia in our patient.The present report indicates that CMV infection should be included in the differential diagnosis for patients with pancreatic hyperamylasemia after SCT.

Key words

Hyperamylasemia Pancreatitis AML Cord blood Transplantation 

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References

  1. 1.
    Zaia JA. Cytomegalovirus infection. In: Blume KG, Forman SJ, Appelbaum FR, eds. Thomas’ Hematopoietic Cell Transplantation. Oxford, UK: Blackwell Scientific Publications; 2004:701–726.Google Scholar
  2. 2.
    Cappell MS, Hassan T. Pancreatic disease in AIDS: a review. J Clin Gastroenterol. 1993;17:254–263.CrossRefPubMedGoogle Scholar
  3. 3.
    Wilcox CM, Forsmark CE, Grendell JH, Darragh TM, Cello J P. Cytomegalovirus-associated acute pancreatic disease in patients with acquired immunodeficiency syndrome: report of two patients. Gastroenterology. 1990;99:263–267.PubMedGoogle Scholar
  4. 4.
    Sinha S, Jha R, Lakhtakia S, Narayan G. Acute pancreatitis following kidney transplantation: role of viral infections. Clin Transplant. 2003;17:32–36.CrossRefPubMedGoogle Scholar
  5. 5.
    Margreiter R, Schmid T, Dunser M, Tauscher T, Hengster P, Konigsrainer A. Cytomegalovirus (CMV)-pancreatitis: a rare complication after pancreas transplantation. Transplant Proc. 1991;23(pt 2):1619–1622.PubMedGoogle Scholar
  6. 6.
    Herline AJ, Pinson CW, Wright JK, et al. Acute pancreatitis after cardiac transplantation and other cardiac procedures: case-control analysis in 24,631 patients. Am Surg. 1999;65:819–825.PubMedGoogle Scholar
  7. 7.
    Takahashi S, Iseki T, Ooi J, et al. Single-institute comparative analysis of unrelated bone marrow transplantation and cord blood transplantation for adult patients with hematologic malignancies. Blood. 2004;104:3813–3820.CrossRefPubMedGoogle Scholar
  8. 8.
    Parenti DM, Steinberg W, Kang P. Infectious causes of acute pancreatitis. Pancreas. 1996;13:356–371.CrossRefPubMedGoogle Scholar
  9. 9.
    Shore T, Bow E, Greenberg H, et al. Pancreatitis post-bone marrow transplantation. Bone Marrow Transplant. 1996;17:1181–1184.PubMedGoogle Scholar
  10. 10.
    Nieto Y, Russ P, Everson G, et al. Acute pancreatitis during immunosuppression with tacrolimus following an allogeneic umbilical cord blood transplantation. Bone Marrow Transplant. 2000;26:109–111.CrossRefPubMedGoogle Scholar
  11. 11.
    Salomone T, Tosi P, Raiti C, et al. Clinical relevance of acute pancreatitis in allogeneic hemopoietic stem cell (bone marrow or peripheral blood) transplants. Dig Dis Sci. 1999;44:1124–1127.CrossRefPubMedGoogle Scholar
  12. 12.
    Kawakami T, Mitsui T, Sendo D, et al. Acute pancreatitis following hematopoietic stem cell transplantation: prevalence and cause of pancreatic amylasemia [in Japanese]. Rinsho Ketsueki. 2002;43:176–182.PubMedGoogle Scholar
  13. 13.
    Ko CW, Gooley T, Schoch HG, et al. Acute pancreatitis in marrow transplant patients: prevalence at autopsy and risk factor analysis. Bone Marrow Transplant. 1997;20:1081–1086.CrossRefPubMedGoogle Scholar
  14. 14.
    Tomonari A, Iseki T, Ooi J, et al. Cytomegalovirus infection following unrelated cord blood transplantation for adult patients: a single institute experience in Japan. Br J Haematol. 2003;121:304–311.CrossRefPubMedGoogle Scholar
  15. 15.
    Colebunders R, Van den Abbeele K, Fleerackers Y, Bols K, Lachenal M, Van Damme L. Two AIDS patients with life-threatening pancreatitis successfully treated, one with ganciclovir the other with foscarnet. Acta Clin Belg. 1994;49:229–232.PubMedGoogle Scholar

Copyright information

© The Japanese Society of Hematology 2006

Authors and Affiliations

  • Akira Tomonari
    • 1
  • Satoshi Takahashi
    • 1
  • Kashiya Takasugi
    • 1
  • Jun Ooi
    • 1
  • Nobuhiro Tsukada
    • 1
  • Takaaki Konuma
    • 1
  • Tohru Iseki
    • 1
  • Arinobu Tojo
    • 1
  • Shigetaka Asano
    • 1
    • 2
  1. 1.Department of Hematology/OncologyThe Institute of Medical Science The University of TokyoTokyoJapan
  2. 2.Integrative Bioscience & Biomedical Engineering, School of Science & EngineeringWaseda UniversityTokyoJapan

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