Akgül Murat, Yazıcı Cenk, Ateş Hüseyin, Altın Enes, Turgut Burhan
Urology Department and Faculty of Medicine, Tekirdağ Namık Kemal University, Tekirdağ, Turkey.
Hematology Department, Faculty of Medicine, Tekirdağ Namık Kemal University, Tekirdağ, Turkey.
J Endourol Case Rep. 2020 Dec 29;6(4):339-342. doi: 10.1089/cren.2020.0066. eCollection 2020.
Hemophagocytic syndrome (HS) is a syndromic complex that is categorized in the group of histiocytic disorders associated with macrophages. A 39-year-old male patient was admitted to the outpatient clinic with complaint of left flank pain. A 1 cm kidney stone was found in the upper pole of left kidney at radiologic imaging. The patient underwent retrograde intrarenal surgery (RIRS) with no peroperative complication. High fever and increasing of acute-phase reactants were observed at postoperative first day. Besides resistant fever, pancytopenia developed despite the appropriate antibiotherapy. The urine and blood cultures were sterile. After multidisciplinary consultation, bone marrow sampling was performed. Microscopic examination of the bone marrow material revealed that the macrophage cells phagocyted the erythrocytes, which was compatible with HS. Unfortunately despite the appropriate medical HS treatment, the patient died due to multiorgan failure at the 21st day of RIRS. HS is a significantly rare complication after RIRS, which was presented initially with postoperative fever. HS should be kept in mind if the patient had resistant fever and pancytopenia despite the appropriate antibiotherapy.
噬血细胞综合征（HS）是一种综合征性复合体，归类于与巨噬细胞相关的组织细胞疾病组。一名39岁男性患者因左侧腰痛主诉入住门诊。影像学检查发现左肾上极有一枚1厘米的肾结石。患者接受了逆行肾内手术（RIRS），术中无并发症。术后第一天观察到高热和急性期反应物增加。除了持续性发热外，尽管进行了适当的抗生素治疗，仍出现了全血细胞减少。尿液和血液培养均无菌。经过多学科会诊后，进行了骨髓采样。骨髓材料的显微镜检查显示巨噬细胞吞噬了红细胞，这与HS相符。不幸的是，尽管对HS进行了适当的药物治疗，但患者在RIRS术后第21天因多器官衰竭死亡。HS是RIRS术后一种极为罕见的并发症，最初表现为术后发热。如果患者在接受适当的抗生素治疗后仍有持续性发热和全血细胞减少，应考虑HS。
