利什曼病继发噬血细胞综合征1例报道

doi:10.16150/j.1671-2870.2022.04.018

诊断学理论与实践 ›› 2022, Vol. 21 ›› Issue (04): 524-526.doi: 10.16150/j.1671-2870.2022.04.018

利什曼病继发噬血细胞综合征1例报道

熊新海¹, 黎佳¹, 丁小松¹, 纪从从¹, 石厚荣¹^,², 项明洁¹^,²()

1.上海交通大学医学院附属瑞金医院无锡分院检验科,江苏无锡 214000
2.上海交通大学医学院附属瑞金医院检验科,上海 200025

收稿日期:2022-01-20 出版日期:2022-08-25 发布日期:2022-11-07
通讯作者: 项明洁 E-mail:mjxiang123456@126.com

Leishmaniasis with secondary hemophagocytic syndrome: a case report

XIONG Xinhai¹, LI Jia¹, DING Xiaosong¹, JI Congcong¹, SHI Hourong¹^,², XIANG Minjie¹^,²()

1. Department of Laboratory, Wuxi Branch, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Jiangsu, Wuxi 214000, China
2. Department of Laboratory, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China

Received:2022-01-20 Online:2022-08-25 Published:2022-11-07
Contact: XIANG Minjie E-mail:mjxiang123456@126.com

摘要/Abstract

摘要：

利什曼病是利什曼原虫引起的感染,不同种的利什曼原虫引起不同的临床综合征。噬血细胞综合征（hemophagocytic syndrome,HPS）是一种多种因素介导的、免疫相关的全身炎性反应综合征。本文报道江苏无锡地区医院接诊的1例外院拟诊“不明原因发热、结缔组织病”而治疗无效的男性患者,经临床表现分析、西部山区务工史问询,予以病原学及基因检查,最终确诊为利什曼病继发HPS患者。采用葡萄糖酸锑钠治疗利什曼病,根据HPS治疗1994方案（HLH-94）,患者病情好转后出院。利什曼病继发HPS时,病情发展快,临床上不常见,容易漏诊。本次报道1例东部平原地区接诊的患者,值得临床工作者注意。

关键词: 利氏曼原虫病, 噬血综合征, 发热

Abstract:

Leishmaniasis is an infection caused by Leishmania. Different species of Leishmania cause different clinical syndromes. Hemophagocytic syndrome (HPS) is an immune related systemic inflammatory response syndrome mediated by many factors. This paper reported that one male patient with “fever of unknown origin, connective tissue disease” who was not effectively treated and was admitted to the Wuxi District Hospital in Jiangsu Province. After the analysis of clinical manifestations and the inquiry of the working history in the western mountain area, the patient was finally diagnosed as HPS secondary to Leishmaniasis by etiological and genetic examination. The patient was treated with antimony sodium gluconate for Leishmaniasis, according to the 1994 scheme of hemophagocytic syndrome treatment (HLH-94), and was discharged after his condition improved. When HPS secondary to Leishmaniasis, the disease develops rapidly. It is not common, and is easy to miss diagnosis. This paper reports a case of a patient in the eastern plain area, which the doctors should pay more attention to in clinic.

Key words: Leishmaniasis, Hemophagocytic syndrome, Fever

中图分类号:

R735

熊新海, 黎佳, 丁小松, 纪从从, 石厚荣, 项明洁. 利什曼病继发噬血细胞综合征1例报道[J]. 诊断学理论与实践, 2022, 21(04): 524-526.

XIONG Xinhai, LI Jia, DING Xiaosong, JI Congcong, SHI Hourong, XIANG Minjie. Leishmaniasis with secondary hemophagocytic syndrome: a case report[J]. Journal of Diagnostics Concepts & Practice, 2022, 21(04): 524-526.

图/表 1

参考文献 14

[1]	宋瑞, 吕琳, 谭嘉禾, 等. 利什曼病合并噬血综合征1例[J]. 现代医药卫生, 2020, 36(12):1942-1944.
	Song R, Lv L, Tan JH, et al. Leishmaniasis complicated with hemophagocytic syndrome: a case report[J]. J Mod Med & Health, 2020, 36(12):1942-1944
[2]	张鸿娟, 黄本林, 杨雪婷, 等. 1例内脏利什曼病死亡病例诊治体会[J]. 检验医学, 2020, 35(10):1083-1086.
	Zhang HJ, Huang BL, Yang XT. Diagnosis and treatment experience of 1 case of visceral leishmaniasis death[J]. Lab Med, 2020, 35(10):1083-1086.
[3]	袁宏, 唐红, 张跃新. 中国利什曼原虫感染诊断和治疗专家共识[J]. 中华传染病杂志, 2017, 35(9):513-518.
	Yuan H, Tang H, Zhang YX. Expert consensus on diagnosis and treatment of Leishmania sinensis infection in China[J]. Chin J Infect Med, 2017, 35(9):513-518.
[4]	唐雪梅, 赵晓东. 噬血细胞综合征遗传特点与免疫发病机制[J]. 中国实用儿科杂志, 2012, 27(10):744-747.
	Tang XM, Zhao XD. Genetic characteristics and immune pathogenesis of hemophagocytic syndrome[J]. Chinese Journal of Practical Pediatrics, 2012, 27(10):744-747.
[5]	李红, 赵亚楠, 赵丽琴, 等. 山西省1例再发内脏利什曼病患者诊治体会[J]. 中华地方病学杂志, 2019(3):247-248.
	Li H, Zhao YN, Zhao LQ, et al. Diagnosis and treatment experience of a patient with recurrent visceral leishmaniasis in Shanxi Province[J]. Chinese Journal of Endemiology, 2019(3):247-248
[6]	Henter JI, M Aricò, Egeler R M, et al. HLH-94: a treatment protocol for hemophagocytic lymphohistiocytosis[J]. Med Pediatr Oncol, 1997, 28(5):342-347. pmid: 9121398
	Henter J I, M Aricò, Egeler R M, et al. HLH-94: 噬血细胞性淋巴组织细胞增多症的治疗方案. 组织细胞学会HLH研究小组. 医学儿科杂志, 1997, 28(5):342-347. pmid: 9121398
[7]	郑玉华, 白永飞, 帖萍, 等. 2010-2019年山西省人群内脏利什曼病流行特征分析[J]. 中国寄生虫学与寄生虫病杂志, 2021, 39(3):352-358.
	Zheng YH, Bai YF, Tie P, et al. Epidemiological characteristics of visceral leishmaniasis in shanxi population from 2010 to 2019[J]. Chinese Journal of Parasitology and Parasitic Diseases, 2021, 39(3):352-358.
[8]	管立人, 高春花. 利什曼病及其防治[J]. 中国寄生虫学与寄生虫病杂志, 2018, 36(4):418-424,428.
	Guan LR, Gao CH. Leishmaniasis and its control[J]. Chinese Journal of Parasitology and Parasitic Diseases, 2018, 36(04):418-424+428.
[9]	赵彤, 刘永清, 张健, 等. 1例输入性黑热病病例的调查[J]. 预防医学论坛, 2020, 26(1):74-75.
	Zhao T, Liu YQ, Zhang J, et al. Investigation of 1 case of imported kala-azar[J]. Prevent Med Tri, 2020, 26(1):74-75.
[10]	凌攀, 王晓凤, 赵仪, 等. 2015-2019年四川省疾控黑热病病例流行特征分析[J]. 解放军预防医学杂志, 2020, 38(4):63-65.
	Ling P, Wang XF, Zhao Y, et al. Epidemiological characteristics of disease-controlled black fever cases in Sichuan Province, 2015-2019[J]. PLA Journal of Preventive Medicine, 2020, 38(4):63-65.
[11]	World Health Organization. Report of a meeting of the WHO Expert Committee on the Control of Leishmaniases[R]. Geneva, Switzerland, 2010.
[12]	中华医学会儿科学分会血液学组. 噬血细胞性淋巴组织细胞增生症诊疗建议[J]. 中华儿科杂志, 2012, 50(11):821-825.
	Hematology Group of Science Branch of Chinese Medical Association. Recommendations for the diagnosis and treatment of hemophagocytic lymphohistoplasia[J]. Chinese Journal of Pediatrics, 2012, 50(11): 821-825.
[13]	康艳. 骨髓检查确诊黑热病3例[J]. 临床医药文献电子杂志, 2020, 7(23):174,194.
	Kang Y. Bone marrow examination confirmed 3 cases of kala-azar[J]. Electronic Journal of Clinical Medical Literature, 2020, 7(23):174,194.
[14]	叶梅, 魏立. 疑难黑热病诊治1例体会并文献复习[J]. 临床医药文献电子杂志, 2020, 7(5):1,3.
	Ye M, Wei L. Diagnosis and treatment of difficult black fever in a case and literature review[J]. Electronic Journal of Clinical Medical Literature, 2020, 7(5):1,3.

利什曼病继发噬血细胞综合征1例报道

Leishmaniasis with secondary hemophagocytic syndrome: a case report

RichHTML

PDF (PC)

可视化

摘要/Abstract

引用本文

使用本文

图/表 1

参考文献 14

相关文章 4

编辑推荐

Metrics

本文评价

[1]	陈芸, 丰青, 陈沁, 汤一鸣, 陈骊莎, 金铭, 邓雪芹, 韩祎明, 龚瑾. DMAIC模型在发热门诊流程管理优化中的探索研究[J]. 诊断学理论与实践, 2022, 21(02): 252-256.
[2]	金燕萍, 朱敏华, 江铭. 临床输血不良反应情况分析及预防措施探讨[J]. 诊断学理论与实践, 2016, 15(05): 503-506.
[3]	何礼贤. 发热性疾病诊断的实践和思考[J]. 诊断学理论与实践, 2016, 15(05): 540-543.
[4]	沈军, 蔡颖, 徐潜, 曹兴午, 鄢盛恺,. 恶性疟原虫感染1例的误诊分析[J]. 诊断学理论与实践, 2009, 8(03): 338-340.