Ohno T, Shirasaka A, Sugiyama T, Furukawa H
Department of Internal Medicine, Ohtsu Red Cross Hospital, Japan.
Int J Hematol. 1996 Oct;64(3-4):263-6. doi: 10.1016/0925-5710(96)00495-1.
While various infectious agents have been reported to induce hemophagocytic syndrome (HPS), protozoan malaria-associated HPS has not been documented. We describe a patient with Plasmodium falciparum malaria complicated by HPS. A 24-year old man with a history of recent travel in tropical areas was hospitalized with high fever and hepatosplenomegaly. Blood smear showed many of the erythrocytes infected with the ring form of P. falciparum. Laboratory data disclosed bicytopenia with coagulopathy, a high serum level of LDH, hyperferritinemia and hypercytokinemia. Bone marrow smear demonstrated proliferation of mature histiocytes with vivid hemophagocytosis. He was free from other active, disseminated viral, bacterial and fungal infections which have been reported to induce HPS. He recovered rapidly from HPS after resolution of the original malarial infection.
虽然已有多种感染因子被报道可诱发噬血细胞综合征（HPS），但原生动物疟疾相关的HPS尚未见文献记载。我们描述了一名患有恶性疟原虫疟疾并并发HPS的患者。一名有近期热带地区旅行史的24岁男性因高热和肝脾肿大入院。血涂片显示许多红细胞被恶性疟原虫环状体感染。实验室数据显示存在双血细胞减少伴凝血病、血清乳酸脱氢酶水平升高、高铁蛋白血症和高细胞因子血症。骨髓涂片显示成熟组织细胞增生并伴有明显的噬血细胞现象。他没有其他已报道可诱发HPS的活动性播散性病毒、细菌和真菌感染。在原有的疟疾感染消退后，他迅速从HPS中康复。
