Hemophagocytic syndrome: An unusual manifestation of acute human immunodeficiency virus infection
Hemophagocytic syndrome: An unusual manifestation of acute human immunodeficiency virus infection
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DOI：
10.1007/bf02983819
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发表时间：
2003-12-01
影响因子：
2.1
通讯作者：
Chiou, TJ
中科院分区：
文献类型：
--
作者：
Chen, TL;Wong, WW;Chiou, TJ
一名18岁的异性恋男子因发烧、寒战、喉咙痛和干咳8天住院。他在入院前4个月内与新伴侣发生性关系。入院时，患者的临床表现符合噬血细胞综合征（HPS）。随后从骨髓和淋巴结标本病理学上确定是否存在hernophagocytosis。详尽的诊断性检查未能发现任何致病病因，2次静脉注射免疫球蛋白（IVIG）后症状改善，每次剂量为0.5 mg/kg，2次给药间隔1周。在患者初次就诊后3个月，诊断为急性人类免疫缺陷病毒（HIV）感染，患者从诊断时起接受了高效抗逆转录病毒治疗（HAART）。患者在接下来的2年中保持良好。HPS在HIV感染的晚期已经被描述过，但是HPS在急性感染的血清转换期间是罕见的。然而，我们非常明确地建议，急性HIV感染应列入HPS的潜在原因清单。IVIG治疗似乎是一种适当的治疗方式，HAART也可以有效预防急性HIV感染患者HPS复发。国际血液学杂志2003;78：450-452. (C)2003年日本血液学会。
An 18 year-old heterosexual man was hospitalized because of fever, chills, a sore throat, and a dry cough for 8 days. He had had sexual intercourse with a new partner within the 4 months prior to admission. At admission, the patient presented a clinical picture compatible with hemophagocytic syndrome (HPS). The presence of hernophagocytosis was subsequently determined pathologically from bone marrow and lymph node specimens. An exhaustive diagnostic work-up failed to reveal any causative etiology, the symptoms improving after 2 doses of intravenous immunoglobulin (IVIG) infusion, given at a dose of 0.5 mg/kg each, the 2 doses being administered 1 week apart. Three months subsequent to the patient's initial presentation, acute human immunodeficiency virus (HIV) infection was diagnosed, and the patient received highly active antiretrovirus therapy (HAART) from the time of diagnosis. The patient remained well for the following 2 years. HPS in the advanced stages of HIV infection has previously been described, but HPS during seroconversion of an acute form of the infection is rare. We most definitely suggest, however, that acute HIV infection be included in the list of potential causes of HPS. IVIG therapy appears to be an appropriate therapeutic modality, and HAART also is effective, for prevention of recurrence of HPS in a patient with acute HIV infection. Int J Hematol. 2003;78:450-452. (C) 2003 The Japanese Society of Hematology.