Ramon I, Libert M, Guillaume M P, Corazza F, Karmali R
Service de médicine interne, CHU Brugmann, Université Libre de Bruxelles, Bruxelles, Belgique.
Acta Clin Belg. 2010 Jul-Aug;65(4):276-8. doi: 10.1179/acb.2010.059.
We describe a case of recurrent haemophagocytic syndrome (HS) in an HIV-infected patient.The first episode was associated with active human herpesvirus 8 infection and progressive Kaposi's sarcoma which was successfully treated with splenectomy, foscarnet and chemotherapy. The second episode was triggered by a Clostridium difficile colitis and resolved completely after treatment with metronidazole only. Recurrent HS has rarely been described in adult patients out of the setting of relapsing malignancy or autoimmune disease.The chronic immune dysregulation and suppression due to HIV-infection may predispose our patient to development of associated HS. Prognosis of HS remains poor, especially in HIV-infected patients. Rapidly unmasking the causative factor and timely instauration of adequate treatment are critical and may improve outcome.
我们描述了一例HIV感染患者复发性噬血细胞综合征(HS)的病例。首次发作与活跃的人类疱疹病毒8感染及进展性卡波西肉瘤相关,通过脾切除术、膦甲酸钠和化疗成功治疗。第二次发作由艰难梭菌性结肠炎引发,仅用甲硝唑治疗后完全缓解。在复发性恶性肿瘤或自身免疫性疾病背景之外,成人患者中复发性HS鲜有报道。HIV感染所致的慢性免疫失调和抑制可能使我们的患者易患相关的HS。HS的预后仍然很差,尤其是在HIV感染患者中。迅速揭示病因并及时开始适当治疗至关重要,可能改善预后。