Diwan A G, Shewale Rahul, Iyer Shivakumar, Nisal Amit, Agrawa Prakhar
J Assoc Physicians India. 2014 Jan;62(1):58-61.
Macrophage activation syndrome is a potentially life threatening phenomenon characterised by aggressive proliferation of macrophages and T lymphocytes leading to haemophagocytosis of other blood cells and multi organ failure. Here we present a very unusual combination of leptospirosis and scrub typhus infection leading to macrophage activation syndrome. Scrub typhus associated with macrophage activation syndrome has rarely been reported in India. A 40 year old female presented with high grade fever, seizures, bodyache, arthralgia and severe breathlessness. Investigations revealed persistent thrombocytopenia, impaired liver function tests, renal dysfunction, leptospiral IgM ELISA positive and a positive Weil Felix test. There was evidence of haemophagocytosis in bone marrow. Macrophage activation syndrome if left untreated has been associated with rapidly fatal outcome and early treatment can help us save that one precious thing..called life..!
巨噬细胞活化综合征是一种潜在的危及生命的现象，其特征为巨噬细胞和T淋巴细胞的过度增殖，导致对其他血细胞的噬血细胞作用和多器官功能衰竭。在此，我们报告了一例非常罕见的钩端螺旋体病和恙虫病感染合并导致巨噬细胞活化综合征的病例。在印度，与巨噬细胞活化综合征相关的恙虫病鲜有报道。一名40岁女性出现高热、癫痫发作、全身疼痛、关节痛和严重呼吸困难。检查发现持续性血小板减少、肝功能检查受损、肾功能障碍、钩端螺旋体IgM ELISA阳性以及外斐试验阳性。骨髓中有噬血细胞现象的证据。巨噬细胞活化综合征若不治疗，往往会导致迅速死亡，而早期治疗有助于挽救那宝贵的东西——生命！
