Department of Infectious Diseases, Baoji People's Hospital Affiliated to Yan'an University, Baoji, 721000, Shaanxi province, China.
BMC Infect Dis. 2019 Jun 4;19(1):492. doi: 10.1186/s12879-019-4122-0.
Hemophagocytic lymphohistiocytosis (HLH) is a life-threatening disease characterized by an excessive systemic inflammatory response, which can be classified as primary HLH (pHLH) and secondary HLH (sHLH). Viruses are the primary pathogens causing sHLH. Hemorrhagic fever with renal syndrome (HFRS) is a rodent-borne disease caused by hantaviruses. Its main characteristics include fever, circulatory collapse with hypotension, hemorrhage, and acute kidney injury. The case of HFRS presented with sHLH is very rare in clinic. We reported the HFRS inducing by Hantaan virus (HTNV) presented with sHLH as the first case in Shaanxi province of west China.
A case of HFRS in 69-year-old Chinese woman, which had persistent fever, cytopenia, coagulopathy, ferritin significantly increased, hepatosplenomegaly and superficial lymphadenopathy. The hemophagocytosis was found in bone marrow, which was consistent with the characteristics of the HLH. The patient recovered completely after timely comprehensive treatments.
HTNV should be considered as one of the underlying viruses resulting in hemophagocytosis, and if occurs, the early diagnosis and rapid therapeutic intervention are very important to the prognosis of sHLH.
噬血细胞性淋巴组织细胞增生症（HLH）是一种危及生命的疾病，其特征为全身炎症反应过度，可分为原发性 HLH（pHLH）和继发性 HLH（sHLH）。病毒是引起 sHLH 的主要病原体。肾综合征出血热（HFRS）是一种由汉坦病毒引起的啮齿动物源性疾病。其主要特征包括发热、低血压性循环衰竭、出血和急性肾损伤。临床上 HFRS 合并 sHLH 极为罕见。我们报道了首例中国西部陕西省由汉坦病毒（HTNV）引起的 HFRS 合并 sHLH。
一名 69 岁中国女性，HFRS 患者，持续性发热，血细胞减少，凝血功能障碍，铁蛋白显著升高，肝脾肿大和浅表淋巴结肿大。骨髓中发现噬血细胞，符合 HLH 的特征。经过及时的综合治疗，患者完全康复。
HTNV 应被视为引起噬血细胞的潜在病毒之一，如果发生噬血细胞性疾病，早期诊断和快速治疗干预对 sHLH 的预后非常重要。
