A successfully treated case of disseminated tuberculosis-associated hemophagocytic syndrome and multiple organ dysfunction syndrome.
We report the case of a patient who presented with disseminated tuberculosis-associated hemophagocytic syndrome (HPS). A 40-year-old man was admitted because of fatigue, fever, and renal dysfunction. Chest radiograph and computed tomography scan showed diffuse reticulonodular shadow, and Mycobacterium tuberculosis was identified. Peripheral blood counts decreased rapidly, and bone marrow aspiration revealed hemophagocytosis by macrophages. Despite antituberculous and steroid pulse therapy, multiple organ dysfunction syndrome developed. After plasma exchange and continuous hemodiafiltration were started, hypercytokinemia and vital signs improved dramatically. Although disseminated tuberculosis-associated HPS carries a poor prognosis, acute blood purification may be an effective means of treating HPS involving multiple organ dysfunction syndrome.
Goto
S
S
Departments of Medicine, Pathology, and Surgery, Shinrakuen Hospital, Niigata, Japan. gotos@med.niigata-u.ac.jp
Aoike
I
I
Shibasaki
Y
Y
Morita
T
T
Miyazaki
S
S
Shimizu
T
T
Suzuki
M
M
D000328:Adult; D006801:Humans; D008297:Male; D010587:Phagocytosis / Q000502:physiology*; D012121:Respiration, Artificial; D013577:Syndrome; D014391:Tuberculosis, Miliary / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology