Oh Hong Sang, Kim Moonsuk, Lee Jeong-Ok, Kim Haeryoung, Kim Eu Suk, Park Kyoung Un, Kim Hong Bin, Song Kyoung-Ho
Department of Internal Medicine Department of Laboratory Medicine Department of Pathology, Seoul National University Bundang Hospital, Seongnam, South Korea.
Medicine (Baltimore). 2016 Aug;95(31):e4476. doi: 10.1097/MD.0000000000004476.
Severe fever with thrombocytopenia syndrome (SFTS) is a new emerging zoonosis. Hemophagocytic lymphohistiocytosis (HLH) is a life-threatening syndrome caused by hyperinflammation. Here, we report the case of SFTS-associated HLH.
A 62-year-old man was admitted to local hospital with 8 days of fever and chill. He had leukopenia, thrombocytopenia, and developed seizure. An attending physician examined bone marrow to rule out hematologic malignancy. He was transferred to tertiary referral hospital for suspicious HLH. We decided to confirm its histologic feature for sure. Bone marrow and liver biopsy showed hemophagocyotic histiocytes. Serological tests for other infections were all negative except SFTS virus polymerase chain reactions (PCRs) as positive from serum, bone marrow, bronchoalveolar lavage fluid, and liver biopsy specimen. A definitive diagnosis was SFTS-associated HLH. During 2 weeks of conservative treatment, he succeeded in recovery from multiple organ failure.
SFTS should be considered one of differential diagnosis of HLH. In certain endemic areas, SFTS infection deserves clinicians' attention because it can be presented hematologic diseases as HLH.
发热伴血小板减少综合征（SFTS）是一种新出现的人畜共患病。噬血细胞性淋巴组织细胞增生症（HLH）是一种由过度炎症引起的危及生命的综合征。在此，我们报告一例与SFTS相关的HLH病例。
一名62岁男性因发热、寒战8天入住当地医院。他有白细胞减少、血小板减少，并出现癫痫发作。主治医生检查骨髓以排除血液系统恶性肿瘤。他因疑似HLH被转至三级转诊医院。我们决定确定其组织学特征。骨髓和肝脏活检显示噬血细胞组织细胞。除血清、骨髓、支气管肺泡灌洗液和肝脏活检标本的SFTS病毒聚合酶链反应（PCR）呈阳性外，其他感染的血清学检查均为阴性。确诊为与SFTS相关的HLH。在2周的保守治疗期间，他成功地从多器官功能衰竭中康复。
SFTS应被视为HLH的鉴别诊断之一。在某些流行地区，SFTS感染值得临床医生关注，因为它可表现为类似HLH的血液系统疾病。
