Successful treatment of hemophagocytic lymphohistiocytosis in a trauma patient: a case report.

Young Soo Chung, Jihoon Kim
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Abstract

Hemophagocytic lymphohistiocytosis (HLH) is a rare, life-threatening hyperinflammatory syndrome characterized by excessive activation of the immune system. This case report describes an unusual presentation of HLH triggered by severe trauma from a motorcycle accident, which is a departure from traditional associations with infections, malignancies, or autoimmune conditions. A 40-year-old man with multiple traumatic injuries developed persistent fever, pancytopenia, and elevated inflammatory markers following orthopedic surgery. Despite empiric antibiotic therapy, his condition deteriorated, exhibiting high fever, skin rash, hepatic dysfunction, and marked elevation of ferritin levels (32,901 ng/mL). Bone marrow biopsy confirmed the diagnosis of HLH, and treatment was initiated according to the HLH-2004 protocol, which included methylprednisolone, intravenous immunoglobulin, and immunosuppressive therapy. The patient demonstrated significant clinical improvement and was discharged after 37 days, with no recurrence observed during the follow-up period. This case underscores the need to consider HLH in trauma patients presenting with unexplained inflammatory responses and illustrates that prompt diagnosis and aggressive treatment can lead to successful outcomes.

嗜血细胞淋巴组织细胞增多症(HLH)是一种罕见的、危及生命的高炎症综合征,其特点是免疫系统过度激活。本病例报告描述了因摩托车事故造成的严重创伤而引发的 HLH 的不寻常表现,这与传统的感染、恶性肿瘤或自身免疫性疾病不同。一名 40 岁的男子因多处外伤在骨科手术后出现持续发热、全血细胞减少和炎症指标升高。尽管他接受了经验性抗生素治疗,但病情恶化,表现出高烧、皮疹、肝功能异常和铁蛋白水平明显升高(32,901 纳克/毫升)。骨髓活检证实了 HLH 的诊断,并根据 HLH-2004 方案开始了治疗,包括甲基强的松龙、静脉注射免疫球蛋白和免疫抑制疗法。患者的临床症状明显好转,37 天后出院,随访期间未发现复发。该病例强调了在创伤患者出现不明原因的炎症反应时考虑 HLH 的必要性,并说明及时诊断和积极治疗可获得成功的结果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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