title: Hemophagocytic syndrome in a patient with rheumatoid arthritis.
abstract: A 76-year-old man with rheumatoid arthritis, who had been treated with oral prednisolone and methotrexate, presented with high fever and generalized fatigability. Laboratory data demonstrated marked pancytopenia, which we first regarded as a side effect of methotrexate, and leucovorin was administered with granulocyte-colony stimulating factor and transfusions. Because no recovery was recognized, however, bone marrow aspiration was performed, by which hemophagocytic syndrome was diagnosed. After corticosteroid pulse therapy was initiated, the patient's symptoms were rapidly attenuated and laboratory data rapidly normalized.
authors.affiliation: Department of Orthopaedic Surgery, Osaka Rosai Hospital, 1179-3 Nagasone-Cho, Sakai, 591-8025, Japan.
authors.forename: Hideki
authors.initials: H
authors.lastname: Tsuboi
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Iwata
authors.forename: Akihide
authors.initials: A
authors.lastname: Nampei
authors.forename: Masato
authors.initials: M
authors.lastname: Matsushita
authors.forename: Kenrin
authors.initials: K
authors.lastname: Shi
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D000368:Aged; D018501:Antirheumatic Agents / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000150:complications* / Q000188:drug therapy*; D006801:Humans; D051359:Lymphohistiocytosis, Hemophagocytic / Q000150:complications* / Q000188:drug therapy*; D008297:Male; D008727:Methotrexate / Q000627:therapeutic use*
chemical_list: D000305:Adrenal Cortex Hormones; D018501:Antirheumatic Agents; D008727:Methotrexate