Tuberculosis-associated hemophagocytic syndrome in a hemodialysis patient: case report and review of the literature.
We present an unusual hematologic manifestation of tuberculosis in a hemodialysis patient. A 37-year-old man was admitted because of fever, anorexia, and weight loss which developed 3 months earlier. He previously received a renal transplant and commenced hemodialysis 1 year ago. Physical examination revealed hepatomegaly, and peripheral blood counts revealed pancytopenia. The delayed bone marrow biopsy demonstrated marked hemophagocytosis, granuloma and tubercle bacilli by the acid-fast stain. The clinical course was fatal and he died without definite treatment. Through this case, we would like to recommend early bone marrow biopsy and antituberculosis therapy if fever of unknown origin, anorexia, weight loss, hepatomegaly and pancytopenia develop in patients undergoing dialysis.
Yang
C W
CW
Department of Internal Medicine, Kangnam St. Mary's Hospital, Catholic University Medical College, Seoul, Korea.
Lee
J H
JH
Kim
Y G
YG
Kim
Y O
YO
Lee
S H
SH
Kim
B K
BK
Bang
B K
BK
D000328:Adult; D001772:Blood Cell Count; D001853:Bone Marrow / Q000473:pathology; D017809:Fatal Outcome; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D010198:Pancytopenia / Q000150:complications / Q000473:pathology; D010587:Phagocytosis / Q000502:physiology*; D006435:Renal Dialysis / Q000009:adverse effects*; D014397:Tuberculosis, Pulmonary / Q000150:complications*