Yamanouchi J, Yamauchi Y, Yokota E, Matsumoto I
Department of Internal Medicine, Matsuyama Red Cross Hospital, Ehime.
Ryumachi. 1998 Oct;38(5):731-4.
A 62-year-old man with 16 year-history of rheumatoid arthritis (RA) was admitted due to progressive pancytopenia, general fatigue, and high fever. He was treated with 5 mg methotrexate weekly in RA. His bone marrow examination revealed a decreased nuclear cell count (2.1 x 10(4)/microliter), megakaryocyte count (16/microliter), and macrophages phagocytizing blood cells (13.2%), indicating the presence of hemophagocytic syndrome. No infections agent was detected in cultures derived from his blood or other sources. The serological tests for several viruses revealed no obvious viral etiology. The systemic lymphonodes were not swelling. Administration of 40 mg prednisolone daily improved his abnormal hematological findings. This is a case of RA accompanied by hemophagocytic syndrome, which is a rare complication of RA.
一名患有16年类风湿关节炎（RA）病史的62岁男性因进行性全血细胞减少、全身乏力和高热入院。他在类风湿关节炎治疗中每周使用5毫克甲氨蝶呤。他的骨髓检查显示核细胞计数减少（2.1×10⁴/微升）、巨核细胞计数减少（16/微升）以及巨噬细胞吞噬血细胞（13.2%），提示存在噬血细胞综合征。从他的血液或其他来源培养未检测到感染病原体。几种病毒的血清学检测未发现明显的病毒病因。全身淋巴结未肿大。每日给予40毫克泼尼松龙改善了他的异常血液学表现。这是一例伴有噬血细胞综合征的类风湿关节炎病例，噬血细胞综合征是类风湿关节炎罕见的并发症。
