Chien Chih-Chiang, Chiou Tzeon-Jye, Lee Ming-Yang, Hsiao Liang-Tsai, Kwang Wei-Kang
Division of Medical Oncology, Department of Medicine, Department of Pathology, Taipei Veterans General Hospital and National Yang-Ming University, 201, Sec 2, Shih-Pai Road, Taipei 112, Taiwan.
Int J Hematol. 2004 May;79(4):334-6. doi: 10.1532/ijh97.a10315.
Hemophagocytic syndrome (HPS) is a clinicopathological reflection of uncontrolled activation of macrophages. To our knowledge, only a few cases of tuberculosis-associated HPS in hemodialysis have been reported in the English literature. We report a case of tuberculosis-associated HPS during hemodialysis. Bone marrow aspiration showed histiocytosis with hemophagocytosis; in addition, results of acid-fast staining and polymerase chain reaction showed the presence of acid-fast bacilli. Mycobacterium tuberculosis was subsequently cultured from sputum. The patient received late treatment with antituberculosis agents combined with intravenous immunoglobulin and had a poor response. On the basis of the results in this case, we recommend early bone marrow and tuberculous examination for patients undergoing maintenance hemodialysis who have fever of unknown origin.
