Ohta Ryuichi, Sano Chiaki
Community Care, Unnan City Hospital, Unnan, JPN.
Community Medicine Management, Shimane University Faculty of Medicine, Izumo, JPN.
Cureus. 2023 Jul 26;15(7):e42514. doi: 10.7759/cureus.42514. eCollection 2023 Jul.
Thrombocytopenia, Anasarca, myeloFibrosis, Renal dysfunction, and Organomegaly (TAFRO) syndrome is a rare and complex medical condition characterized by a combination of symptoms, including thrombocytopenia, anasarca, myelofibrosis, renal dysfunction, and organomegaly. The diagnosis of TAFRO syndrome can be challenging because of its rarity, overlapping symptoms, heterogeneity, and lack of specific biomarkers. We describe the case of a 77-year-old female who presented with fatigue and generalized arthralgia as chief complaints. Initially, the condition demonstrated no inflammatory manifestations for three months, and the patient was diagnosed with fibromyalgia. However, her symptoms progressed, and she eventually developed anasarca, thrombocytopenia, hepatosplenomegaly, and renal dysfunction. After using biopsy to exclude various diseases, we established a diagnosis of TAFRO syndrome and administered prednisolone and tocilizumab. The diagnosis was based on the clinical progression of anasarca, thrombocytopenia, hepatosplenomegaly, and renal dysfunction. To diagnose TAFRO syndrome, the intensive exclusion of various critical diseases is mandatory. Additionally, considering the gradual and fluctuating clinical course of TAFRO syndrome, physicians in rural areas should meticulously assess systemic symptoms in older patients.
血小板减少、全身水肿、骨髓纤维化、肾功能不全和器官肿大（TAFRO）综合征是一种罕见且复杂的病症，其特征为血小板减少、全身水肿、骨髓纤维化、肾功能不全和器官肿大等多种症状的组合。由于TAFRO综合征罕见、症状重叠、异质性以及缺乏特异性生物标志物，其诊断可能具有挑战性。我们描述了一名77岁女性的病例，她以疲劳和全身关节痛为主诉就诊。最初，该病情在三个月内未表现出炎症迹象，患者被诊断为纤维肌痛。然而，她的症状进展，最终出现了全身水肿、血小板减少、肝脾肿大和肾功能不全。在通过活检排除各种疾病后，我们确诊为TAFRO综合征，并给予泼尼松龙和托珠单抗治疗。诊断基于全身水肿、血小板减少、肝脾肿大和肾功能不全的临床进展情况。要诊断TAFRO综合征，必须严格排除各种严重疾病。此外，考虑到TAFRO综合征临床病程的渐进性和波动性，农村地区的医生应仔细评估老年患者的全身症状。
