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一名患有噬血细胞性淋巴组织细胞增生症并伴有传染性单核细胞增多症的患者发生致命性感染性休克。

Fatal Septic Shock in a Patient with Hemophagocytic Lymphohistiocytosis Associated with an Infectious Mononucleosis.

作者信息

Berlot Giorgio, Tomasini Ariella, Zandonà Lorenzo, Leonardo Eugenio, Bussani Rossana, Zarrillo Nadia

机构信息

University of Trieste, Department of Anesthesia and Intensive Care, Cattinara Hospital, 447, 34149, Trieste, Italy.

University of Trieste, Department of Pathology, Cattinara Hospital, 447, 34149, Trieste, Italy.

出版信息

Case Rep Crit Care. 2018 Sep 25;2018:9756050. doi: 10.1155/2018/9756050. eCollection 2018.

Abstract

The authors describe the case of a young woman who developed a clinical pictures resembling a septic shock-related multiple organ dysfunction syndrome a couple of months after having been diagnosed suffering from a hemophagocytic lymphohistiocytosis associated with an infectious mononucleosis. Despite the aggressive treatment, which included antibiotics, vasopressors, IV immunoglobulins, and the use of an extracorporeal device aimed to remove mediators released both during sepsis and the cytokine storm determined by the hemophagocytic lymphohistiocytosis, the patient died. At the autopsy, an extremely uncommon aggressive lymphoma of Epstein-Barr virus-positive T-lymphocytes with systemic involvement was discovered.

摘要

作者描述了一名年轻女性的病例,该女性在被诊断患有与传染性单核细胞增多症相关的噬血细胞性淋巴组织细胞增生症几个月后,出现了类似脓毒性休克相关多器官功能障碍综合征的临床症状。尽管进行了积极治疗,包括使用抗生素、血管加压药、静脉注射免疫球蛋白,以及使用一种体外装置以清除脓毒症期间和噬血细胞性淋巴组织细胞增生症引发的细胞因子风暴期间释放的介质,但患者仍死亡。尸检时,发现了一种极其罕见的、累及全身的爱泼斯坦-巴尔病毒阳性T淋巴细胞侵袭性淋巴瘤。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e45a/6176343/ca854a217c69/CRICC2018-9756050.001.jpg

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