Cho Jaehee, Song Youhyun, Lee Jiyeon, Lee Daeun, Go Yunsun, Kang Hee Cheol
Yonsei University College of Medicine, Seoul, Korea.
Department of Family Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
Korean J Fam Med. 2021 May;42(3):250-254. doi: 10.4082/kjfm.19.0130. Epub 2020 May 22.
Pancytopenia represents a unique challenge for primary care doctors and its etiological causes encompass various specialties, including hematology and rheumatology. Despite the existence of effective tests such as bone marrow biopsy and immunoassays to rule out the potential causes of pancytopenia, it is often difficult to pinpoint the exact diagnosis. In this case report, we have described such a 'gray zone' patient, who presented with pancytopenia, neutropenia, and splenomegaly, and was being treated for fungal pneumonia before being transferred to Severance Hospital (department of family medicine). As the patient had a 10-year history of multiple, long-term hospital admissions that were having a severely debilitating impact on the quality of life, we performed a partial splenic embolization as a potential cure for the symptoms. Although this induced acute blood count recovery, it failed to prevent eventual mortality from septic shock.
全血细胞减少症对基层医疗医生来说是一项独特的挑战,其病因涉及多个专科领域,包括血液学和风湿病学。尽管存在诸如骨髓活检和免疫测定等有效的检查手段来排除全血细胞减少症的潜在病因,但往往难以明确确切诊断。在本病例报告中,我们描述了这样一位“灰色地带”患者,该患者出现全血细胞减少、中性粒细胞减少和脾肿大,在转至Severance医院(家庭医学科)之前正在接受真菌性肺炎的治疗。由于该患者有长达10年的多次长期住院病史,这对其生活质量产生了严重的削弱影响,我们实施了部分脾栓塞术作为缓解症状的一种潜在治疗方法。尽管这促使血细胞计数迅速恢复,但未能防止患者最终死于感染性休克。