一名脐带血移植受者发生的结核相关噬血细胞性淋巴组织细胞增生症。
Tuberculosis-associated hemophagocytic lymphohistiocytosis in an umbilical cord blood transplant recipient.
作者信息
Long Bing, Cheng Lei, Lai Shu-Ping, Zhang Jing-Wen, Sun Yan-Ling, Lai Wen-Xin, Zhang Hai-Yan, Lu Ying, Lin Dong-Jun, Li Xu-Dong
机构信息
Department of Hematology, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
Department of Ophthalmology, First People's Hospital of Shenzhen, Shenzhen, China.
出版信息
Clin Chim Acta. 2017 May;468:111-113. doi: 10.1016/j.cca.2016.12.028. Epub 2016 Dec 28.
BACKGROUND
Hemophagocytic lymphohistiocytosis (HLH) is a rare and potentially fatal condition that can be primary or secondary. Secondary HLH due to Mycobacterium tuberculosis (TB) is uncommon. We report a case of tuberculosis-associated HLH in an umbilical cord blood transplant (UCBT) recipient and discuss its clinical characteristics and challenges.
METHODS
Hematologic investigations, bone marrow aspirates, Xpert MTB/RIF test of TB with peripheral blood were performed. Immune modulation with anti-TB therapy was initiated.
RESULTS
Subsequent treatment with anti-TB treatment resulted rapid clinical response and disease remission.
CONCLUSION
It is important to consider TB as one of the underlying cause of HLH in high-risk patients, particularly those in immunodeficient states. Early diagnosis and treatment can improve the survival rates of patients with tuberculosis-associated HLH.
背景
噬血细胞性淋巴组织细胞增生症（HLH）是一种罕见的、可能致命的疾病，可分为原发性或继发性。由结核分枝杆菌（TB）引起的继发性HLH并不常见。我们报告了一例脐带血移植（UCBT）受者中与结核病相关的HLH病例，并讨论其临床特征和挑战。
方法
进行了血液学检查、骨髓穿刺、外周血结核分枝杆菌Xpert MTB/RIF检测。开始采用抗结核治疗进行免疫调节。
结果
随后的抗结核治疗导致了快速的临床反应和疾病缓解。
结论
将结核病视为高危患者（尤其是免疫缺陷状态患者）HLH的潜在病因之一很重要。早期诊断和治疗可提高结核病相关HLH患者的生存率。
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