表现为噬血细胞性淋巴组织细胞增生症的内脏利什曼病。
Visceral leishmaniasis presenting as haemophagocytic lymphohistiocytosis.
作者信息
Vanhinsbergh Lewis, Mason Aaron, Godfrey Andrew
机构信息
Haematology, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK
Haematology, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK.
出版信息
BMJ Case Rep. 2019 Dec 8;12(12):e232576. doi: 10.1136/bcr-2019-232576.
A 53-year-old man presented with a number of hospital admissions for investigation of fever of unknown origin. He became gradually weaker with significant weight loss, pancytopenia and progressive splenomegaly over a 6-month period of extensive investigation. This was undertaken at different NHS hospitals with involvement of multiple medical specialists. Clinical criteria for haemophagocytic lymphohistiocytosis were met. Following investigation, this was felt likely secondary to a low-grade lymphoma of the spleen, necessitating splenectomy for diagnostic and therapeutic purposes. Ultimately, this risky surgical procedure was avoided when positive serology led to successful treatment with amphotericin B.
一名53岁男性因不明原因发热多次入院检查。在为期6个月的广泛检查过程中，他逐渐变得虚弱，体重显著减轻，出现全血细胞减少和进行性脾肿大。这一情况发生在不同的国民保健服务（NHS）医院，涉及多名医学专家。符合噬血细胞性淋巴组织细胞增生症的临床标准。经过检查，认为这可能继发于脾脏的低度淋巴瘤，因此需要进行脾切除术以达到诊断和治疗目的。最终，当血清学检查呈阳性，使得使用两性霉素B治疗成功时，避免了这一有风险的外科手术。
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