Kanaji S, Okuma K, Tokumitsu Y, Yoshizawa S, Nakamura M, Niho Y
First Department of Internal Medicine, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
Am J Gastroenterol. 1998 Oct;93(10):1956-9. doi: 10.1111/j.1572-0241.1998.00554.x.
We herein report a case of hemophagocytic syndrome that developed in a 25-yr-old man with fulminant ulcerative colitis and presumed acute pancreatitis. Physical examination on admission showed a chronically ill, delirious patient with an upper abdominal mass. Peripheral blood showed progressive pancytopenia and bone marrow aspirate smears revealed hypocellular bone marrow with an increase of histiocytes showing prominent hemophagocytosis. Plain abdominal radiography revealed toxic megacolon. Both ultrasound and computed tomography showed the enlargement of the pancreas, thus indicating presumed acute pancreatitis. No apparent neoplasms or viral or bacterial infections, which are normally reported to be the cause of hemophagocytic syndrome, were detected. The patient was successfully treated with high doses of prednisolone and gamma-globulin.
我们在此报告一例噬血细胞综合征，该病例发生在一名25岁患有暴发性溃疡性结肠炎并推测患有急性胰腺炎的男性患者身上。入院时体格检查发现患者病情慢性化、神志不清，上腹部有肿块。外周血显示进行性全血细胞减少，骨髓穿刺涂片显示骨髓细胞减少，组织细胞增多，呈现明显的噬血细胞现象。腹部平片显示中毒性巨结肠。超声和计算机断层扫描均显示胰腺肿大，提示推测为急性胰腺炎。未检测到通常报道的作为噬血细胞综合征病因的明显肿瘤、病毒或细菌感染。该患者通过大剂量泼尼松龙和γ-球蛋白成功治愈。
