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題 名 | Reactive Hemophagocytic Syndrome in Patient with Acute Hepatitis B: Report of a Case=反應性血球吞噬症候群在急性B型肝炎之病患一病例報告 |
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作 者 | 陳進生; 楊東和; 趙有誠; 唐鴻舜; 嚴助成; 陳宇欽; 李恒昇; | 書刊名 | 中華民國消化系醫學雜誌 |
卷 期 | 15:1 1998.03[民87.03] |
頁 次 | 頁8-13 |
分類號 | 415.533 |
關鍵詞 | 急性B型肝炎; 血球吞噬症候群; 咖瑪球蛋白; Acute hepatitis B; Hemophagocytic syndrome; γ-globulin; |
語 文 | 英文(English) |
中文摘要 | 反應性血球吞噬症候群為罕見且高致死率(30~100%)的疾病,早期症狀類似急 性肝炎,故易被誤診而延誤治療時機。造成反應性血球吞噬症候群之常見常見致病因為感染、 淋巴瘤、自體免疫疾病及藥物。本文報告-20歲男性因嘔吐、黃疸、持續高燒、茶色尿、 頭痛及肝功能指數異常而住院。血液B型肝炎標記檢查發現罹患急性B型肝炎,其他肝炎標 記及病毒血清學檢查皆為陰性。腹部電腦斷層攝影檢查發現包括肝脾腫大、主動脈旁淋巴結 腫大、及輕度腹水。經肝臟切片及骨髓抹片檢查證實為急性B型肝炎併發反應性血球吞噬症 候群,病人接受靜脈注射類固醇及珈瑪球蛋白治療後,病況改善而辦理出院。國內曾有A型 合併C型肝炎併發反應性血球吞噬症候群之病例報告,經治療後,病例仍死亡。故提出此一 治療成功病例以供臨床醫師處置類似案例之參考。(中消醫誌1998; 15: 8-13) |
英文摘要 | Reactive hemophagocytic syndrome is a high mortality rate disorder. This syndrome may mimic acute hepatitis in the early stages and is easily misdiagnosed; consequently, it has poor prognosis for delayed treatment. The common pathogenesis of reactive hemophagocytic syndrome are infection, lymphoma, autoimmune disease and drugs. We report a 20-year-old male who suffered from nausea, vomiting, tea-color urine, jaundice, high fever, headache and abnormal liver function. The laboratory data confirmed the impression of acute hepatitis B. Bone marrow aspiration and liver biopsy showed hemophagocytosis. Intravenous Dexamethasone and γ-globulin were prescribed. After two months treatment, he was discharged in stable condition. Acute hepatitis A with coexistent hepatitis C virus infection associated with hemophagocytic syndrome had been reported in our country, but the case died after treatment. Therefore, we present this successfully treated case as an example for physicians in managing those cases with the same disorder. (Gastroenterol J Taiwan 1998; 15: 8-13) |
本系統中英文摘要資訊取自各篇刊載內容。