Hathirat P, Numhom S, Chuansumrit A, Chantarojanasiri T, Sirinavin S, Isarangkura P
Department of Pediatrics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
J Med Assoc Thai. 1993 Oct;76 Suppl 2:240-3.
A 3-year-old boy with Wilms' tumor, post operative left nephrectomy stage, had HTS on day 99 of the combined chemotherapy which lasted for more than 20 days. He had severe respiratory distress due to a moderate amount of ascites and marked pleural effusion. Because of high fever, thrombocytopenia and marked hemphagocytosis in the bone marrow, he received IVIG for 2 days. Normal platelet count and markedly decreased pleural fluid were attained within 3 days. He subsequently tolerated full doses of combined chemotherapeutic agents with an additional one (doxorubicin). In cases of HTS, IAHS should be suspected. The bone marrow should be done and treatment accordingly so that there is no need to decrease, the dosage of chemotherapeutic agents afterwards.
一名3岁患有肾母细胞瘤的男孩，处于术后左肾切除阶段，在持续20多天的联合化疗第99天出现高热综合征（HTS）。由于中等量腹水和明显胸腔积液，他出现严重呼吸窘迫。因高热、血小板减少及骨髓中明显噬血细胞现象，他接受了2天静脉注射免疫球蛋白（IVIG）治疗。3天内血小板计数恢复正常，胸腔积液明显减少。随后他耐受了全剂量联合化疗药物以及额外一种药物（阿霉素）。对于HTS病例，应怀疑为噬血细胞性淋巴组织细胞增生症（IAHS）。应进行骨髓检查并相应治疗，以便之后无需减少化疗药物剂量。
