Stéphan F, Thiolière B, Verdy E, Tulliez M
Service d'Anesthésie-Réanimation Chirurgicale, Hôpital Tenon, Paris, France.
Clin Infect Dis. 1997 Nov;25(5):1159-64. doi: 10.1086/516086.
We conducted a study to assess the incidence and outcome of hemophagocytic histiocytosis (HH) in thrombocytopenic patients with sepsis syndrome or septic shock and to define the possible associations between HH, disseminated intravascular coagulation (DIC), and platelet-associated IgG (PAIgG) in promoting thrombocytopenia. Twenty immunocompetent thrombocytopenic patients were included. Bone marrow aspirates were obtained from each patient to identify hemophagocytic histiocytes. Coagulation parameters, PAIgG levels, and bacterial and viral infections were studied. Twelve patients with HH were identified. The presence of DIC and of PAIgG were often associated with this disease. No herpesvirus infection was demonstrated. Eight of the 12 patients with HH and four of the eight patients without HH died (P = NS). The results of this study suggest that HH could be involved in the development of thrombocytopenia in immunocompetent patients with sepsis syndrome or septic shock. HH does not seem to be associated with increased mortality.
我们开展了一项研究，以评估脓毒症综合征或感染性休克的血小板减少患者中噬血细胞性组织细胞增多症（HH）的发生率及转归，并明确HH、弥散性血管内凝血（DIC）和血小板相关IgG（PAIgG）在促发血小板减少方面可能存在的关联。纳入了20例免疫功能正常的血小板减少患者。从每位患者获取骨髓穿刺样本以识别噬血细胞性组织细胞。研究了凝血参数、PAIgG水平以及细菌和病毒感染情况。识别出12例HH患者。DIC和PAIgG的存在常与该病相关。未证实有疱疹病毒感染。12例HH患者中的8例以及8例非HH患者中的4例死亡（P=无显著性差异）。本研究结果提示，HH可能参与了免疫功能正常的脓毒症综合征或感染性休克患者血小板减少的发生过程。HH似乎与死亡率增加无关。
