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作者报道了静脉给予抗霉菌药两性霉素B引起致命性脑白质病的病例.例1为16岁女孩,患急性原淋巴细胞性白血病;例2为22岁男性患者,由于骨髓发育不良综合征行骨髓移植术.此两例患者都接受两性霉素B合并颅脑放射的治疗,导致以人格改变和精神混乱,迅速发展为运动不能性缄默为特征的亚急性进行性神经系统疾患.神经影像研究发现大脑白质(尤其是前额区)弥漫性未强化的异常,包括CT扫描低密度区和T_2—加权磁共振扫描高信号区.尸检证实为弥漫性非炎症性白质病,并伴有大量的星形神经胶质细胞增生症、脱髓鞘以及大脑半球白质的泡沫巨噬细胞浸润.两例患者均无机会性感染或神经系统新生物浸润的迹象.本文作者评述了多烯类(大环内酯物)抗生素诸如两性霉素B可能具有白细胞毒的根据.
The authors report cases of fatal leukoencephalopathy caused by intravenous administration of antimycotic amphotericin B. Example 1 is a 16-year-old girl suffering from acute lymphoblastic leukemia; Example 2 is a 22-year-old male patient with a myelodysplastic syndrome And bone marrow transplantation, both of which received treatment with amphotericin B combined with craniocerebral radiation, leading to the rapid development of subacute progressive neurological disorders characterized by motor disturbed personality with personality changes and mental disorders. The study found diffuse and non-enhanced abnormalities in the white matter (especially the prefrontal area) of the brain, including low-density CT scan areas and high-T 2 -weighted MR scan areas, and confirmed a diffuse non-inflammatory leukoencephalopathy with a large number of Astroglial hyperplasia, demyelination, and foamy macrophage infiltration of white matter in the cerebral hemispheres.2 No evidence of either opportunistic infections or neo-biological infiltration in the nervous system was observed in both patients.The authors reviewed the effects of polyenes Lactone) Antibiotics such as amphotericin B may have leukemia based on.