Hemophagocytic syndrome as a complication of acute pancreatitis: A case report
Hemophagocytic syndrome as a complication of acute pancreatitis: A case report
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急性胰腺炎并发症之一的噬血细胞综合征：一例报告
DOI：
10.12998/wjcc.v8.i11.2364
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发表时间：
2020-06-06
影响因子：
1.1
通讯作者：
Hou, Xiao-Hua
中科院分区：
文献类型：
--
作者：
Han, Chao-Qun;Xie, Xin-Ru;Hou, Xiao-Hua
背景吞噬血细胞综合征(HPS)在急性胰腺炎(AP)患者中很少见。HPS在无任何既往病史的患者中是否为AP的并发症尚不清楚。CASE SUMMARYA，46岁，男性，酗酒后持续腹痛、恶心、呕吐2天。在住院期间，他突然出现皮疹和继发性发烧。实验室结果显示进行性全血细胞减少，肝脏检查异常，以及血清甘油三酯、铁蛋白和乳酸脱氢酶水平升高。然而，没有检测到明显的细菌或病毒感染。他也可能与自身免疫性疾病有关，因为各种自身免疫抗体阳性表达，没有明显的既往病史。最后，骨髓检查显示组织细胞反应性生长和显著的血细胞吞噬功能，从而诊断为HPS。出乎意料的是，患者对免疫抑制治疗反应良好。结论NHPS是一种非常罕见的胰外表现。诊断依赖于骨髓检查，免疫抑制治疗有效。对于有皮肤变化的AP，在临床工作中应考虑HPS的可能性。
BACKGROUNDHaemophagocytic syndrome (HPS) is rarely seen in patients with acute pancreatitis (AP). HPS as a complication of AP in patients without any previous history has not been elucidated.CASE SUMMARYA 46-year-old man was admitted for symptom of persistent abdominal pain, nausea, and vomiting for 2 d after heavy drinking. During hospital stay, he suddenly developed skin rash and a secondary fever. The laboratory findings revealed progressive pancytopenia, abnormal hepatic tests, and elevation of serum triglyceride, ferritin, and lactate dehydrogenase levels. However, apparent bacterial or viral infections were not detected. He was also possibly related to autoimmune diseases because of positive expression of various autoimmune antibodies and no remarkable past history. Finally, the bone marrow examination showed a histiocytic reactive growth and prominent hemophagocytosis, which resulted in a diagnosis of HPS. Unexpectedly, the patient responded well to the immunosuppressive therapy.CONCLUSIONHPS is a very rare extrapancreatic manifestation of AP. The diagnosis relies on bone marrow examination and immunosuppressive therapy is effective. For AP with skin changes, the possibility of HPS should be considered during clinical work.