Dengue Virus-associated Hemophagocytic Syndrome and Dyserythropoiesis: A Case Report

登革熱病毒相關之嗜血症候群及紅血球生成不良－病例報告

盧柏樑(Po-Liang Lu) ； 蕭惠樺(Hui-Hwa Hsiao) ； 蔡季君(Jih-Jin Tsai) ； 陳惇傑(Tun-Chieh Chen) ； 馮明珠(Ming-Chu Feng) ； 陳田柏(Tyen-Po Chen) ； 林勝豐(Sheng-Fung Lin)

《The Kaohsiung Journal of Medical Sciences》 21卷1期 (2005/01) Pp. 34-39

摘要

一位以發燒、白血球增多、血小板低下為初期表徵之33歲男性登革出血熱患者，在沒有大量出血及血管內溶血的情況下其紅血球數目急速下降，經骨髓檢查證實為嗜血症候群及紅血球生成不良。病人病情在支持性治療下恢復，覆檢骨髓檢查也顯示恢復為正常骨髓。這台灣首次報告的登革熱病毒相關之嗜血症候群及紅血球生成不良提供臨床醫師了解嗜血症候群可能和登革熱病毒有關，而此病人在急性症狀期之登革熱血清學檢查為陰性，在疾病恢復期登革熱血清學檢查才呈陽性之情形也可提醒在只做急性期登革熱血清學檢查的情況下可能會誤失登革熱感染之診斷。

關鍵字

嗜血症候群 ； 登革熱

並列摘要

A 33-year-old man had dengue hemorrhagic fever with initial presentation of fever, leukocytosis, and thrombocytopenia. The cause of the subsequent rapid decline in red cell counts without evidence of intravascular hemolysis or massive bleeding was confirmed as hemophagocytosis and dyserythropoiesis by bone marrow study. The patient recovered with supportive care and the bone marrow pattern was normal on repeated bone marrow study. To our knowledge, this is the first reported case of dengue virus-associated hemophagocytosis and dyserythropoiesis in Taiwan. Clinicians should consider that the occurrence of hemophagocytosis and dyserythropoiesis could be due to dengue virus infection. That this dengue virus infection was confirmed by a positive serology result at the convalescent stage but not at the acute symptomatic stage underlines the need for a second dengue serology study, as dengue infection can be missed due to an initial negative serology result.

並列關鍵字

hemophagocytosis ； dengue fever