Ur Rehman Jalil, Wali Ghassan, Sayes Najla M, Maulawi Abdulghani, Aslam Mohammad, Khalid Imran
Department of Haematology, Medicine and Haematopathology, King Faisal Specialist Hospital and Research Centre, Jeddah, Saudi Arabia.
Ann Saudi Med. 2012 Jan-Feb;32(1):86-9. doi: 10.5144/0256-4947.2012.86.
H1N1 is a novel subtype of the influenza A virus. Since its reemergence in 2008, it has been reported to cause a variety of illnesses ranging from mild flu-like symptoms to severe multiorgan failure. We report a case of a young immunocompetent man who presented with progressive shortness of breath and rapidly developed multiorgan dysfunction, including pancytopenia from H1N1 infection during the 2010-2011 influenza season. His H1N1 pneumonia caused severe acute respiratory distress syndrome, respiratory failure requiring mechanical ventilation, rhabdomyolysis, myocarditis, hepatitis, encephalitis, and renal failure. During the diagnostic workup, a bone marrow biopsy was performed, showing hemophagocytosis secondary to the H1N1 infection. Unfortunately the patient died despite aggressive measures. Published reports contain only a few records of H1N1-induced hemophagocytosis. This is the first case report from Saudi Arabia with H1N1-induced secondary hemophagocytosis. It also highlights the fact that the virus is still very virulent and will pose a major annual health risk along with the seasonal influenza for at least the next few years.
H1N1是甲型流感病毒的一种新型亚型。自2008年再次出现以来，据报道它会引发多种疾病，从类似流感的轻微症状到严重的多器官功能衰竭。我们报告一例年轻免疫功能正常男性病例，该患者出现进行性呼吸急促，并迅速发展为多器官功能障碍，包括在2010 - 2011年流感季节因H1N1感染导致的全血细胞减少。他的H1N1肺炎引发了严重的急性呼吸窘迫综合征、需要机械通气的呼吸衰竭、横纹肌溶解、心肌炎、肝炎、脑炎和肾衰竭。在诊断检查过程中，进行了骨髓活检，显示为H1N1感染继发的噬血细胞现象。不幸的是，尽管采取了积极措施，患者仍死亡。已发表的报告中仅有少数关于H1N1诱导噬血细胞现象的记录。这是沙特阿拉伯首例关于H1N1诱导继发性噬血细胞现象的病例报告。它还凸显了这样一个事实，即该病毒仍然极具毒性，至少在未来几年内，它将与季节性流感一起每年构成重大的健康风险。
