论文部分内容阅读
本文报道了1例以头痛和复视为首发症状的嗜血细胞综合征(hemophagocytic syndrome,HPS)成人患者的临床诊治过程。该例女性患者55岁,初始症状表现为头痛和复视,继而出现高热;实验室检查结果显示为全血细胞减少、肝功能异常(包括血清谷丙转氨酶、谷草转氨酶和乳酸脱氢酶水平升高)、高三酰甘油血症、低纤维蛋白原血症和高铁蛋白血症;骨髓穿刺活检结果显示骨髓有核细胞增生减低、3系造血细胞减少,可见嗜血细胞吞噬血小板和中性粒细胞,诊断为HPS。该病例报道提示,对于临床上出现头痛、复视和高热以及外周血检查提示全血细胞减少的患者,应高度怀疑继发性HPS的可能,而尽早进行骨髓穿刺活检是明确诊断的关键。
This article reports the clinical diagnosis and treatment of one adult patient with hemophagocytic syndrome (HPS) with headache and diplopia as the first symptom. The female patient, age 55, had initial symptoms of headache and diplopia followed by fever, and laboratory tests showed pancytopenia, abnormal liver function (including elevated levels of serum alanine aminotransferase, aspartate aminotransferase, and lactate dehydrogenase ), Hypertriglyceridemia, hypofibrinogenemia and hyperferricin; bone marrow biopsy results showed reduced proliferation of bone marrow nucleated cells, decreased hematopoietic cells in 3 lines, phagocytosis of platelets and neutrophils by blood cells, diagnosis For HPS. This case report suggests that patients with clinically headache, diplopia, and hyperthermia as well as peripheral blood tests that suggest pancytopenia should be highly suspected of secondary HPS and that early bone marrow biopsy is the key to a definitive diagnosis.