一名HIV和溃疡性结肠炎病情得到良好控制的患者发生播散性巨细胞病毒感染和噬血细胞性淋巴组织细胞增生症。
Disseminated CMV infection and HLH in a patient with well-controlled HIV and ulcerative colitis.
作者信息
Cockbain Beatrice Clare, Mora Peris Borja, Abbara Aula, So Chun Wah, Cooke Graham
机构信息
Department of Immmunology and Infection, Barts Health NHS Trust, London, UK.
Department of Genitourinary Medicine and HIV, Imperial College Healthcare NHS Trust, London, UK.
出版信息
BMJ Case Rep. 2019 Feb 11;12(2):e227916. doi: 10.1136/bcr-2018-227916.
Abstract
We present a case of haemophagocytic lymphohistiocytosis (HLH) in the context of disseminated cytomegalovirus (CMV) viraemia in a 50-year-old man with well-controlled HIV infection and ulcerative colitis (UC), for which he was receiving azathioprine. Peak CMV viral load was 371 000 copies/ml with evidence of end-organ CMV in the lungs and colon. A bone marrow biopsy showed evidence of haemophagocytosis of platelets, neutrophils and erythrocytes. The azathioprine was stopped, and he received intravenous ganciclovir and corticosteroids with suppression of the CMV viral load and resolution of the HLH.
摘要
我们报告一例50岁男性患者，其HIV感染和溃疡性结肠炎（UC）病情控制良好，正在接受硫唑嘌呤治疗，在播散性巨细胞病毒（CMV）病毒血症背景下发生噬血细胞性淋巴组织细胞增生症（HLH）。CMV病毒载量峰值为371000拷贝/ml，肺部和结肠有终末器官CMV感染的证据。骨髓活检显示有血小板、中性粒细胞和红细胞噬血现象。停用硫唑嘌呤，患者接受静脉注射更昔洛韦和糖皮质激素治疗，CMV病毒载量得到抑制，HLH症状缓解。
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本文引用的文献
1
Hemophagocytic Lymphohistiocytosis Associated with Scrub Typhus: Systematic Review and Comparison between Pediatric and Adult Cases.
Trop Med Infect Dis. 2018 Feb 14;3(1):19. doi: 10.3390/tropicalmed3010019.
2
Hemophagocytic Lymphohistiocytosis: Potentially Underdiagnosed in Intensive Care Units.
Shock. 2018 Aug;50(2):149-155. doi: 10.1097/SHK.0000000000001048.
3
Early onset lysosomal acid lipase deficiency presenting as secondary hemophagocytic lymphohistiocytosis: Two infants treated with sebelipase alfa.
Clin Res Hepatol Gastroenterol. 2018 Oct;42(5):e77-e82. doi: 10.1016/j.clinre.2018.03.012. Epub 2018 Apr 26.
4
Safe usage of anakinra and dexamethasone to treat refractory hemophagocytic lymphohistiocytosis secondary to acute disseminated histoplasmosis in a patient with HIV/AIDS.
BMJ Case Rep. 2017 Oct 4;2017:bcr-2017-221264. doi: 10.1136/bcr-2017-221264.
5
Acute HIV infection presenting as hemophagocytic lymphohistiocytosis: case report and review of the literature.
BMC Infect Dis. 2017 Sep 20;17(1):633. doi: 10.1186/s12879-017-2732-y.
6
Interleukin 1 Receptor Antagonist Anakinra, Intravenous Immunoglobulin, and Corticosteroids in the Management of Critically Ill Adult Patients With Hemophagocytic Lymphohistiocytosis.
J Intensive Care Med. 2019 Sep;34(9):723-731. doi: 10.1177/0885066617711386. Epub 2017 Jun 20.
7
Acute Cytomegalovirus (CMV) Infection Associated with Hemophagocytic Lymphohistiocytosis (HLH) in an Immunocompetent Host Meeting All Eight HLH 2004 Diagnostic Criteria.
Cureus. 2017 Mar 2;9(3):e1070. doi: 10.7759/cureus.1070.
8
The challenging diagnosis of haemophagocytic lymphohistiocytosis in an HIV-infected patient.
BMJ Case Rep. 2015 Oct 28;2015:bcr2015211817. doi: 10.1136/bcr-2015-211817.
9
Hemophagocytic lymphohistiocytosis: review of etiologies and management.
J Blood Med. 2014 Jun 12;5:69-86. doi: 10.2147/JBM.S46255. eCollection 2014.
10
Therapeutic role of anakinra, an interleukin-1 receptor antagonist, in the management of secondary hemophagocytic lymphohistiocytosis/sepsis/multiple organ dysfunction/macrophage activating syndrome in critically ill children*.
Pediatr Crit Care Med. 2014 Jun;15(5):401-8. doi: 10.1097/PCC.0000000000000078.
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