Kim Bongyoung, Choi Yeon Woo, Pai Hyunjoo, Kim Jieun
Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea.
Infect Chemother. 2021 Dec;53(4):802-807. doi: 10.3947/ic.2018.0203. Epub 2018 Nov 1.
Human immunodeficiency virus (HIV) is one of the less common triggers of secondary hemophagocytic lymphohistiocytosis (HLH) in which coagulation disorder is a frequent manifestation. Here, we present a case of HIV-triggered secondary HLH presenting with severe bleeding tendency and fever. Despite high-dose dexamethasone infusion (10 mg/body surface area/day), progressive disseminated intravascular coagulation and thrombocytopenia resulted in massive hemathochezia: the bleeding episode ceased after endoscopic hemoclipping. After then, he took a highly-active antiretroviral therapy (HAART). Eventually, body temperature and overall laboratory findings normalized in response to HAART. Clinicians should not overlook HIV infection as a possible trigger of secondary HLH. In such cases, HAART is the core treatment.
人类免疫缺陷病毒（HIV）是继发性噬血细胞性淋巴组织细胞增生症（HLH）较少见的诱因之一，凝血障碍是其常见表现。在此，我们报告一例由HIV引发的继发性HLH病例，该病例表现为严重出血倾向和发热。尽管输注了高剂量地塞米松（10mg/体表面积/天），但进行性弥散性血管内凝血和血小板减少导致大量便血：在内镜下进行血管夹闭后出血停止。此后，患者接受了高效抗逆转录病毒治疗(HAART )。最终，随着HAART治疗，体温和各项实验室检查结果恢复正常。临床医生不应忽视HIV感染作为继发性HLH的可能诱因。在这种情况下，HAART是核心治疗方法。
