急性肝炎樣の発症を示し, 重篤な経過をたどつたhemophagocytic syndromeの一部検例

概要

論文の詳細を見る
We report a case of 29 yrs old man who was suffered from hemophagocytic syndrome with an onset of severe acute liver damage. He was admitted to our hospital because of fever, malaise and jaundice. On admission, he showed marked hepatosplennomegaly, high fever and severe liver damage accompanied by disseminated intravascular coagulation (DIC). There was no evidence of bacterial infection and also several serum markers for hepatitis A, B, C, cytomegalo virus and Ebstein Barr virus. Bone marrow aspiration revealed an increase in, matured histiocytes with an evidence of phagocytosis and atypical lymphocytes, however, malignant proliferation could not be identified. His illness became worse rapidly, so predonisolone was administered for a suspicion of lympho-reticular malignancy. After administration, liver damage and DIC were transiently improved, however, either high dose Methyl-predonisolone or combination therapy of anti-cancer agents could not be effective when the recurrence of fever, liver damage and DIC.<BR>He died on 38th hospital day. In autopsy, the diagnosis of hemophagocytic syndrome was compatible because of the evidence of an increase in matured histiocytes with phagocytosis in the liver, spleen and bone-marrow. Especially in the liver, numerous histiocytes were infiltrated in the sinusoid area, though aggregated hepatocytes lay scattered. Retrospectively, proceded common cold like symptom and increased atypical lymphocytes may be induced by virus-associated hemophagocytic syndrome (VAHS). Only four cases of fetal VAHS had been reported in our country. This case indicated that HS (VAHS) should be included in defferential diagnosis of severe acute liver damage.
社団法人日本肝臓学会の論文

急性肝炎樣の発症を示し, 重篤な経過をたどつたhemophagocytic syndromeの一部検例

スポンサーリンク

概要

著者

関連論文

スポンサーリンク