Chinese Medical Sciences Journal ›› 2020, Vol. 35 ›› Issue (4): 371-376.doi: 10.24920/003603

• 病例报告 • 上一篇    下一篇

妊娠引起的噬血细胞性淋巴组织细胞增生症:病例报告与文献回顾

赵杰1,杨翼萌2,明树红2,*()   

  1. 1肿瘤内科/分子肿瘤学国家重点实验室,国家癌症中心/国家肿瘤临床医学研究中心/中国医学科学院北京协和医学院肿瘤医院,北京 100021,中国
    2呼吸与重症医学科,北京医院,北京 100730,中国
  • 收稿日期:2019-05-08 接受日期:2019-09-06 出版日期:2020-12-31 发布日期:2020-09-29
  • 通讯作者: 明树红 E-mail:qzf301@sohu.com

Pregnancy-Induced Hemophagocytic Lymphohistiocytosis: A Case Report and Literature Review

Jie Zhao1,Yimeng Yang2,Shuhong Ming2,*()   

  1. 1Department of Medical Oncology, State Key Laboratory of Molecular Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100021, China
    2Department of Respiratory and Critical Care Medicine, Beijing Hospital, Beijing 100730, China
  • Received:2019-05-08 Accepted:2019-09-06 Published:2020-12-31 Online:2020-09-29
  • Contact: Shuhong Ming E-mail:qzf301@sohu.com

摘要:

噬血细胞性淋巴组织细胞增生症(hemophagocytic lymphohistiocytosis, HLH)是一种罕见但严重威胁健康的疾病,其典型特征为免疫反应失调和过度的炎症反应。目前关于妊娠引起的HLH鲜有报道。本文报道了一例自怀孕17周以来持续发烧21天的30岁孕妇,通过一系列详尽的检查排除感染、自身免疫性疾病和恶性肿瘤等可能病因,给予广谱抗生素和地塞米松等治疗后,病情仍在进展。患者被诊断为妊娠引起的HLH。终止妊娠并继续使用糖皮质激素控制过度炎症反应后,该患者疾病痊愈。妊娠引起的HLH若不及时给予有效的治疗,会严重威胁生命健康。进一步研究以提高HLH早期诊断和病因鉴定至关重要。

关键词: 噬血细胞作用, 过度炎症, 妊娠

Abstract:

Hemophagocytic lymphohistiocytosis (HLH) is a rare but devastating disease characterized by dysregulated immune response and hyperinflammation. To our knowledge, pregnancy-induced HLH has been rarely reported in the literature. A 30-year-old pregnant woman presented persistent fever for 21 days since 17 weeks of pregnancy. The possible etiologies such as infection, autoimmune disorder, and malignancy had been ruled out based on a series of exhaustive examinations. The disease progressed despite the use of broad-spectrum antibiotics and dexamethasone. The patient was diagnosed as pregnancy-induced HLH, and finally recovered completely after termination of pregnancy by caesarean and the continuous use of glucocorticoid which played a crucial part in controlling hyperinflammation. Pregnancy-induced HLH could be fatal if effective treatment was not initiated timely. Further studies are needed to improve early diagnosis and etiology identification of HLH.

Key words: hemophagocytosis, hyperinflammation, pregnancy

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