Clinical Study of Infection Associated Hemophagocytic Syndrome

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  • SHIRAISHI Kaori
    First Department of Internal Medicine, Kurume University School of Medicine
  • TANAKA Ken
    First Department of Internal Medicine, Kurume University School of Medicine
  • OKUBO Yasumitsu
    First Department of Internal Medicine, Kurume University School of Medicine
  • SAKAMOTO Akihiko
    First Department of Internal Medicine, Kurume University School of Medicine
  • JOJIMA Hiroto
    First Department of Internal Medicine, Kurume University School of Medicine
  • FUKAHORI Shigeki
    First Department of Internal Medicine, Kurume University School of Medicine
  • FUJIMATSU Yukiko
    First Department of Internal Medicine, Kurume University School of Medicine
  • SHIRAISHI Tsuneaki
    First Department of Internal Medicine, Kurume University School of Medicine
  • HONDA Junichi
    First Department of Internal Medicine, Kurume University School of Medicine
  • OIZUMI Kotaro
    First Department of Internal Medicine, Kurume University School of Medicine

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Other Title
  • 感染症関連血球貪食症候群の臨床的検討
  • カンセンショウ カンレン ケッキュウドンショク ショウコウグン ノ リンショウテキ ケントウ

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Description

Hemophagocytic syndrome (HPS) causes pancytopenia, increased blood LDH level, liver dysfunction, DIC, etc. with macrophages appearing in the bone marrow, spleen, lymph nodes, etc. Adult HPS is mostly secondary to various infections, malignant tumors, etc. and sometimes has a serious outcome. Particularly infection associated HPS (IAHS) is trigged by viral, bacterial and fungal infections. The cases of unknown primary disease and suspected IAHS of unindentified pathogenic microorganism are often encountered in the clinical setting.<BR>The authors compared IAHS and malignant associated HPS (MAHS) and classified IAHS into viral associated HPS (VAHS), bacterial associated HPS (BAHS) and fungal types to compare the test values based on the test findings at the onset in the HPS cases treated at our Department. The patients consisted of 21 HPS cases, 11 IAHS cases (VAHS 4, BAHS 5, fungal 2) and 10 MAHS cases. Based on the test findings (WBC, Hb, Plt, LDH, ferritin, myelogram, cytokines, [IFNα, TNFγ, IL-6, sIL-2R, M-CSF], adhesion molecules [sICAM-1, sVCAM-1, sELAM-1, sL-selectin]) at the onset, a comparison between IAHS and MAHS and among the IAHS cases classified by pathogenic microorganism was made. In the comparison between IAHS and MAHS, the Hb value was significantlly decreased and sIL-2R tended to be increased at the onset in MAHS. When comparing the IAHS cases by pathogenic microorganism, Plt was significantly decreased and sICAM-1 and sVCAM-1 were increased at the onset in the BAHS, The BAHS cases had serious underlying diseases and poor prognosis with high incidence of DIC complications. We are going to accumulate more cases for early diagnosis and treatment of IAHS.

Journal

  • Kansenshogaku Zasshi

    Kansenshogaku Zasshi 74 (8), 630-637, 2000

    The Japanese Association for Infectious Diseases

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