{"created":"2023-06-19T10:43:11.985297+00:00","id":3376,"links":{},"metadata":{"_buckets":{"deposit":"aef34265-68f8-4634-b552-54049d068261"},"_deposit":{"created_by":11,"id":"3376","owners":[11],"pid":{"revision_id":0,"type":"depid","value":"3376"},"status":"published"},"_oai":{"id":"oai:shiga-med.repo.nii.ac.jp:00003376","sets":["6:7:222:223"]},"author_link":["2780","314","7172","806","7245","7601","3219","644","3194","7508","2852","7509"],"item_3_alternative_title_19":{"attribute_name":"タイトル（ヨミ）","attribute_value_mlt":[{"subitem_alternative_title":"ジュウショウ サイセイ フリョウセイ ヒンケツ ニ タイスル ドウホウカン コツズイ イショクゴ ニ ハッショウシタ レシピエント ユライ EBウイルス カンレン イショクゴ リンパ ゾウショクセイ シッカン ノ ハツビョウ キコウ"}]},"item_3_biblio_info_6":{"attribute_name":"書誌情報","attribute_value_mlt":[{"bibliographicIssueDates":{"bibliographicIssueDate":"2019-05-03","bibliographicIssueDateType":"Issued"},"bibliographicIssueNumber":"1","bibliographicPageEnd":"23","bibliographicPageStart":"18","bibliographicVolumeNumber":"32","bibliographic_titles":[{"bibliographic_title":"滋賀医科大学雑誌"}]}]},"item_3_description_4":{"attribute_name":"抄録","attribute_value_mlt":[{"subitem_description":"症例はEBV既感染30歳男性。重症再生不良性貧血に対してEBV未感染HLA一致同胞ドナーよりFludarabine、Cyclophosphamide、antithymocyte-globulinを前処置として骨髄移植を施行した。免疫抑制剤はcyclosporine A、methotrexateを使用した。移植後、著明な合併症なくday 50で退院となった。Day 82より咳嗽、day 86より発熱あり、肺感染症として加療を開始したが呼吸状態は急激に増悪した。Day 93に経気管支肺生検を施行し大型異形リンパ球のびまん性増生を確認、また血液中EBV-DNA 51×10⁴copy/mlと著増していたためEpstein-Barr virus-associated post-transplant lymphoproliferative disorder (EBV-PTLD)と診断した。Rituximab投与、ステロイドパルス療法を施行するも病状回復することなくday 97に永眠された。病理解剖では、両肺、全消化管、肝臓、膵臓、腎臓、骨髄、心臓にEBV-encoded small RNA(EBER)陽性免疫芽球様細胞の浸潤を認めた。腫瘍細胞はレシピエント由来であった。一般的に骨髄移植後PTLDはドナー由来であるが、本症例はレシピエント由来であり、その理由としてEBV既感染患者に対して骨髄非破壊的前処置による骨髄移植を行ったことでレシピエント体内に残存したEBVが再活性化、ドナーがEBV未感染であったためにドナーのEBV特異的細胞障害性T細胞が作用せずにEBV-PTLD発症に至ったと考えられた。","subitem_description_type":"Abstract"}]},"item_3_description_42":{"attribute_name":"資源タイプ","attribute_value_mlt":[{"subitem_description":"Departmental Bulletin Paper","subitem_description_type":"Other"}]},"item_3_identifier_registration":{"attribute_name":"ID登録","attribute_value_mlt":[{"subitem_identifier_reg_text":"10.14999/1521.00012504","subitem_identifier_reg_type":"JaLC"}]},"item_3_publisher_32":{"attribute_name":"出版者","attribute_value_mlt":[{"subitem_publisher":"滋賀医科大学雑誌編集委員会"}]},"item_3_relation_11":{"attribute_name":"DOI","attribute_value_mlt":[{"subitem_relation_name":[{"subitem_relation_name_text":"10.14999/1521.00012504"}],"subitem_relation_type":"isIdenticalTo","subitem_relation_type_id":{"subitem_relation_type_id_text":"http://doi.org/10.14999/1521.00012504","subitem_relation_type_select":"DOI"}}]},"item_3_version_type_15":{"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":"古屋, 彩"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"奥野, 貴史"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"程原, 佳子"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"岩佐, 磨佐紀"}],"nameIdentifiers":[{},{}]},{"creatorNames":[{"creatorName":"藤城, 綾"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"西村, 理恵"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"河原, 真大"}],"nameIdentifiers":[{},{},{}]},{"creatorNames":[{"creatorName":"南口, 仁志"}],"nameIdentifiers":[{},{}]},{"creatorNames":[{"creatorName":"木藤, 克之"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"安藤, 朗"}],"nameIdentifiers":[{},{},{}]},{"creatorNames":[{"creatorName":"仲山, 貴永"}],"nameIdentifiers":[{},{}]},{"creatorNames":[{"creatorName":"杉原, 洋行"}],"nameIdentifiers":[{},{}]}]},"item_files":{"attribute_name":"ファイル情報","attribute_type":"file","attribute_value_mlt":[{"accessrole":"open_date","date":[{"dateType":"Available","dateValue":"2019-05-30"}],"displaytype":"detail","filename":"jsums3201p018.pdf","filesize":[{"value":"642.7 kB"}],"format":"application/pdf","licensetype":"license_note","mimetype":"application/pdf","url":{"label":"jsums3201p018","url":"https://shiga-med.repo.nii.ac.jp/record/3376/files/jsums3201p018.pdf"},"version_id":"f79bebe2-7ed0-41ee-b59c-09b5567e3609"}]},"item_keyword":{"attribute_name":"キーワード","attribute_value_mlt":[{"subitem_subject":"EBV-PTLD","subitem_subject_scheme":"Other"},{"subitem_subject":"EBV未感染ドナー","subitem_subject_scheme":"Other"},{"subitem_subject":"レシピエント由来PTLD","subitem_subject_scheme":"Other"},{"subitem_subject":"再生不良性貧血","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":"departmental bulletin paper","resourceuri":"http://purl.org/coar/resource_type/c_6501"}]},"item_title":"重症再生不良性貧血に対する同胞間骨髄移植後に発症したレシピエント由来EBウイルス関連移植後リンパ増殖性疾患の発病機構","item_titles":{"attribute_name":"タイトル","attribute_value_mlt":[{"subitem_title":"重症再生不良性貧血に対する同胞間骨髄移植後に発症したレシピエント由来EBウイルス関連移植後リンパ増殖性疾患の発病機構"},{"subitem_title":"Pathogenesis of Epstein-Barr virus-associated post-transplant lymphoproliferative disorder of recipient origin after allogeneic bone marrow transplantation in a patient with severe aplastic anemia.","subitem_title_language":"en"}]},"item_type_id":"3","owner":"11","path":["223"],"pubdate":{"attribute_name":"公開日","attribute_value":"2019-05-30"},"publish_date":"2019-05-30","publish_status":"0","recid":"3376","relation_version_is_last":true,"title":["重症再生不良性貧血に対する同胞間骨髄移植後に発症したレシピエント由来EBウイルス関連移植後リンパ増殖性疾患の発病機構"],"weko_creator_id":"11","weko_shared_id":-1},"updated":"2023-06-19T11:15:30.479195+00:00"}