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噬血细胞性淋巴组织细胞增生症合并感染:病例报告。

Hemophagocytic Lymphohistiocytosis Associated to Infection: A Case Report.

机构信息

Department of Cardiology, The First Hospital of Jilin University, Changchun, China.

出版信息

Front Immunol. 2021 Jul 12;12:684805. doi: 10.3389/fimmu.2021.684805. eCollection 2021.

Abstract

This is a case analysis of a 73-year-old Chinese man admitted to the cardiac intensive care unit (ICU) with fever and general pain. Based on the patient's initial condition of multi-organ function impairment and increased serum ferritin, and after a series of examinations, the patient was diagnosed with Klebsiella pneumonia-induced hemophagocytic lymphohistiocytosis (HLH). Meropenem and dexamethasone were used in combination to treat the patient, and the results were very successful. In this case report, it is further suggested that is a possible trigger of HLH, and a combination of antibiotics and corticosteroids can be effective in treating HLH. It is also recommended that doctors in the ICU of each department should pay attention to the role of hyperferritinemia in the diagnosis of HLH, and ICU admission teams should include ferritin in their monitoring.

摘要

这是一例 73 岁中国男性因发热和全身疼痛入住心脏重症监护病房(ICU)的病例分析。根据患者多器官功能损害和血清铁蛋白升高的初始情况,经过一系列检查,患者被诊断为肺炎克雷伯菌引起的噬血细胞性淋巴组织细胞增生症(HLH)。采用美罗培南和地塞米松联合治疗患者,效果非常成功。在本病例报告中,进一步提示感染可能是 HLH 的一个触发因素,抗生素和皮质类固醇的联合治疗对 HLH 有效。还建议各科室 ICU 的医生应注意铁蛋白在 HLH 诊断中的作用,ICU 入院团队应将铁蛋白纳入监测范围。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5744/8318975/dd9f857f9f9f/fimmu-12-684805-g001.jpg

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