Kala‐azar in a one‐year‐old Swedish child. Diagnostic difficulties because of active hemophagocytosis
Kala‐azar in a one‐year‐old Swedish child. Diagnostic difficulties because of active hemophagocytosis
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一名瑞典一岁儿童因活跃的噬血细胞症而导致诊断困难。
DOI：
10.1111/j.1651-2227.1993.tb12562.x
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发表时间：
1993
期刊：
影响因子：
3.8
通讯作者：
J. Henter
中科院分区：
文献类型：
--
作者：
C. Granert;G. Elinder;A. Öst;J. Henter
一名瑞典一岁男孩在西班牙度假六个月后患上了黑热病。患病一周后到医院就诊时，他表现出发烧、脾肿大和血细胞减少的临床和实验室检查结果。脾脏细针抽吸活检显示噬血细胞增多，细胞因子肿瘤坏死因子-α 和干扰素-γ 的血清水平升高。最初，诊断为噬血细胞性淋巴组织细胞增多症。脾脏涂片和骨髓抽吸的重新评估显示利什曼原虫寄生虫，随后用葡萄糖酸锑钠治疗成功。该患者说明了这两种涉及单核吞噬细胞系统的疾病之间有趣的相似之处以及鉴别诊断中涉及的问题。这个病例也提醒我们地中海国家感染内脏利什曼病的可能性。
A one‐year‐old Swedish boy developed kala‐azar six months after a holiday in Spain. Upon visiting the hospital after one week of illness he demonstrated clinical and laboratory findings of fever, splenomegaly and cytopenia. A fine‐needle aspiration biopsy of the spleen revealed hemophagocytosis and he had increased serum levels of the cytokines tumor necrosis factor‐alpha and interferon‐gamma. Initially, a diagnosis of hemophagocytic lymphohistiocytosis was made. Re‐evaluation of the spleen smears and of the bone marrow aspiration revealed Leishmania parasites and subsequent therapy with sodium stibogluconate was successful. This patient illustrates the interesting similarities between these two disorders involving the mononuclear phagocyte system as well as the problems involved in differential diagnosis. This case also reminds us of the possibility of contracting visceral leishmaniasis in Mediterranean countries.