病例报告

利什曼病继发噬血细胞综合征1例报道

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  • 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

  网络出版日期: 2022-11-07

Leishmaniasis with secondary hemophagocytic syndrome: a case report

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  • 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 date: 2022-01-20

  Online published: 2022-11-07

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。

本文引用格式

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 . DOI: 10.16150/j.1671-2870.2022.04.018

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.

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