Dating violence among male and female youth seeking emergency department care.
Dating violence among male and female youth seeking emergency department care.
复制标题
寻求急诊科护理的男性和女性青少年中的约会暴力。
DOI：
10.1016/j.annemergmed.2014.05.027
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发表时间：
2014
影响因子：
6.2
通讯作者：
Cunningham,RebeccaM
中科院分区：
文献类型：
--
作者：
Singh,Vijay;Walton,MaureenA;Whiteside,LaurenK;Stoddard,Sarah;Epstein-Ngo,Quyen;Chermack,StephenT;Cunningham,RebeccaM
背景巨噬细胞激活综合征（MAS）是系统性红斑狼疮（SLE）患者罕见但潜在致命的表现。MAS的实际发生率仍然未知。SLE中MAS的患病率为0.9%~ 4.6%。延误诊断导致这些患者的死亡率增加。本病例报告2例在印度中部SLE确诊病例中的MAS。讨论MAS是噬血细胞性淋巴组织细胞增生症（HLH）的一个亚型。临床表现为持续高热、肝脾肿大、淋巴结肿大、出血和中枢神经系统功能障碍。它是由免疫系统的不平衡导致免疫细胞的不间断过度刺激引起的。我们报告2例表现为MAS的系统性红斑狼疮。两人均表现为长期发热，抗生素未缓解，肝脾肿大，短时间内出现血细胞减少，血清铁蛋白水平升高。全血细胞计数与转氨酶和血清铁蛋白水平升高的相对变化。然而，有没有出血的表现和中枢神经系统功能障碍found. The患者反应良好，口服环孢素和其他支持性管理，并出院口服steroids.ConclusionFeatures MAS模拟疾病爆发在SLE，使诊断具有挑战性。选择合适的诊断标准是诊断MAS的关键。实验室参数的相对变化沿着强烈的临床怀疑是早期诊断的关键。
BackgroundMacrophage Activation Syndrome (MAS) is a rare but potential fatal manifestation in patients of Systemic Lupus Erythematosus (SLE). The actual incidence of MAS is still unknown. The prevalence of MAS in SLE varies from 0.9 to 4.6%. Delayed diagnosis leads to increased mortality in these patients. This case reports 2 cases of MAS in diagnosed cases of SLE in Central India.DiscussionMAS is a subset of hemophagocytic lymph histiocytosis (HLH). The clinical features include persistent high-grade fever, hepatosplenomegaly, lymphadenopathy, hemorrhagic manifestations and central nervous system dysfunction. It is caused by an imbalance of immune system leading to uninterrupted hyperstimulation of immune cells. We report 2 cases manifesting MAS in SLE. Both presented with long standing fever not relieved on antibiotics, hepatosplenomegaly with developing cytopenias over a short period of time with raised serum ferritin levels. Relative changes in complete blood counts with raised transaminases and raised serum ferritin levels. However, there were no hemorrhagic manifestations and central nervous system dysfunction found. The patients responded well to oral cyclosporine and other supportive management and were discharged on oral steroids.ConclusionFeatures of MAS simulate disease flare up in SLE, making the diagnosis challenging. Selecting a proper diagnostic criterion to diagnose MAS is essential. Relative changes in laboratory parameters along with strong clinical suspicion is the key to early diagnosis.