Soler Rosario Yadira, Garcia Ricardo, Fernandez Sein Alicia
Department of Pediatrics, UPR School of Medicine, San Juan, PR 00936-5067.
Bol Asoc Med P R. 2010 Jan-Mar;102(1):49-54.
Hemophagocytic Syndrome (HS) is a clinico-pathologic entity characterized by activation of T lymphocytes and macrophages. It may be diagnosed in association with malignant, genetic, or autoimmune diseases, but is most linked with Epstein-Barr virus. There are few reports of association between HS and Dengue in pediatrics. Dengue fever, caused by a flavivirus, is an important mosquito-transmitted disease. It can cause increased vascular permeability that leads to a bleeding diathesis or disseminated intravascular coagulation known as dengue hemorrhagic fever (DHF). We present the case of a 10 month-old-female who developed DHF and dengue shock syndrome, requiring admission to intensive care unit. She developed hemophagocytosis diagnosed by bone marrow aspiration and atypical skin changes that have not been previously described in association with dengue fever. This is an unusual case of dengue related hemophagocytic syndrome that adds to the limited pediatric cases reported in literature.
噬血细胞综合征（HS）是一种临床病理实体，其特征为T淋巴细胞和巨噬细胞的激活。它可能与恶性、遗传或自身免疫性疾病相关联而被诊断出来，但与爱泼斯坦-巴尔病毒关系最为密切。儿科中关于HS与登革热之间关联的报道很少。由黄病毒引起的登革热是一种重要的蚊媒传播疾病。它可导致血管通透性增加，进而引发出血倾向或弥散性血管内凝血，即登革出血热（DHF）。我们报告了一例10个月大的女性患儿，她患上了登革出血热和登革休克综合征，需要入住重症监护病房。她通过骨髓穿刺诊断出噬血细胞增多症，并出现了非典型皮肤变化，这些变化此前未曾在与登革热相关的病例中被描述过。这是一例与登革热相关的噬血细胞综合征的罕见病例，为文献中报道的有限儿科病例增添了新内容。
