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Unklare Leberraumforderungen bei einer 19-jährigen Patientin mit akuter myeloischer Leukämie

Unclear liver lesions in a 19-year-old woman with acute myeloid leukemia

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Zusammenfassung

Bei einer 19-jährigen Patientin mit akuter myeloischer Leukämie wurden während der Konsolidierungstherapie neu aufgetretene Leberraumforderungen entdeckt. Wegen unklarer Cholestase war während der Induktionstherapie eine Gallengangsdrainage eingelegt worden. Letztendlich konnte eine atypische Mykobakteriose mit Nachweis von Mycobacterium abscessus diagnostiziert werden. Unter geeigneter antibiotischer Therapie – inklusive dauerhafter ambulanter Applikation über ein tragbares Pumpensystem – konnte trotz der vorliegenden multiplen Resistenzen eine Ausbreitung der Infektion während der chemotherapieassoziierten Neutropenie verhindert und eine Komplettierung der Leukämiebehandlung in kurativer Intention sichergestellt werden.

Abstract

A 19-year old woman with acute myeloid leukemia presented with newly observed liver lesions during ongoing consolidation therapy. Due to unexplained cholestasis during induction, biliary duct drainage was performed. Microbiologic and histologic examinations revealed the presence of atypical mycobacteria, namely Mycobacterium abscessus. With an appropriate antiinfective regime which was continuously administered using a portable pump in the outpatient setting, further mycobacterial spread during simultaneous chemotherapy-associated neutropenia was prevented. Despite multiple bacterial resistance mechanisms, proper treatment of leukemia with curative intention could be ensured.

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Authors and Affiliations

  1. Klinik für Onkologie und Hämatologie, Krankenhaus Barmherzige Brüder Regensburg, Prüfeningerstr. 86, 93049, Regensburg, Deutschland

    B. Braun, M. Schenk & J. Braess

  2. Klinik für Gastroenterologie und interventionelle Endoskopie, Krankenhaus Barmherzige Brüder Regensburg, Regensburg, Deutschland

    A. P. Karl & C. Dierkes

Authors
  1. B. Braun
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  2. A. P. Karl
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  3. C. Dierkes
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  4. M. Schenk
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  5. J. Braess
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Corresponding author

Correspondence to B. Braun.

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Interessenkonflikt

B. Braun, A.P. Karl, C. Dierkes, M. Schenk und J. Braess geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren. Alle Patienten, die über Bildmaterial oder anderweitige Angaben innerhalb des Manuskripts zu identifizieren sind, haben hierzu ihre schriftliche Einwilligung gegeben.

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Redaktion

H. Haller, Hannover (Schriftleitung)

B. Salzberger, Regensburg

C. Sieber, Nürnberg

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Braun, B., Karl, A.P., Dierkes, C. et al. Unklare Leberraumforderungen bei einer 19-jährigen Patientin mit akuter myeloischer Leukämie. Internist 57, 1121–1125 (2016). https://doi.org/10.1007/s00108-016-0104-0

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  • DOI: https://doi.org/10.1007/s00108-016-0104-0

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