title: Pancreatic hyperamylasemia and hyperlipasemia in association with cytomegalovirus infection following unrelated cord blood transplantation for acute myelogenous leukemia.
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/microL 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.
authors.affiliation: Department of Hematology/Oncology, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan. atomonar@ims.u-tokyo.ac.jp
authors.forename: Akira
authors.initials: A
authors.lastname: Tomonari
authors.forename: Satoshi
authors.initials: S
authors.lastname: Takahashi
authors.forename: Kashiya
authors.initials: K
authors.lastname: Takasugi
authors.forename: Jun
authors.initials: J
authors.lastname: Ooi
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Tsukada
authors.forename: Takaaki
authors.initials: T
authors.lastname: Konuma
authors.forename: Tohru
authors.initials: T
authors.lastname: Iseki
authors.forename: Arinobu
authors.initials: A
authors.lastname: Tojo
authors.forename: Shigetaka
authors.initials: S
authors.lastname: Asano
mesh_terms: D000328:Adult; D000681:Amylases / Q000097:blood; D000998:Antiviral Agents / Q000008:administration & dosage; D036101:Cord Blood Stem Cell Transplantation; D003586:Cytomegalovirus Infections / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D017245:Foscarnet / Q000008:administration & dosage; D015774:Ganciclovir / Q000008:administration & dosage; D006801:Humans; D034321:Hyperamylasemia / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology* / Q000821:virology; D015470:Leukemia, Myeloid, Acute / Q000097:blood / Q000150:complications* / Q000628:therapy; D008297:Male; D010195:Pancreatitis / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology* / Q000821:virology; D014184:Transplantation, Homologous
chemical_list: D000998:Antiviral Agents; D017245:Foscarnet; D000681:Amylases; D015774:Ganciclovir