Cassim K M, Gathiram V, Jogessar V B
Department of Medicine, University of Natal, South Africa.
Tuber Lung Dis. 1993 Jun;74(3):208-10. doi: 10.1016/0962-8479(93)90014-O.
A 38-year-old black male is reported with a rare combination of disseminated tuberculosis together with a reactive histiocytic haemophagocytic syndrome and tuberculosis hypersplenism. Tuberculosis and histiocytic haemophagocytosis were diagnosed on bone marrow examination. The pancytopaenia and splenomegaly which were present on admission did not resolve despite adequate anti-tuberculosis chemotherapy. Prior to splenectomy the patient continued to have a marked thrombocytopenia which resulted in recurrent bouts of epistaxis; splenectomy together with tuberculostatic therapy was curative for the condition. The patient remains well with normal blood counts 1 year later.
据报道，一名38岁的黑人男性患有播散性结核病，同时伴有反应性组织细胞性噬血细胞综合征和结核性脾功能亢进，这种情况较为罕见。通过骨髓检查诊断出结核病和组织细胞性噬血细胞增多症。尽管进行了充分的抗结核化疗，但入院时出现的全血细胞减少和脾肿大并未缓解。在脾切除术前，患者持续存在明显的血小板减少症，导致反复鼻出血；脾切除术联合抗结核治疗治愈了该疾病。1年后，患者情况良好，血常规正常。
