Parvovirus B19 감염에 의한 혈구탐식림프조직구증 1예
Parvovirus B19 infection-associated hemophagocytic lymphohistiocytosis
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초록
저자들은 발열을 주소로 내원한 평소 건강하던 16세 남자 환자에서 양측 경부 및 겨드랑이 림프절, 간, 비장종대, 범혈구감소증, 골수흡인검사에서는 핵내 봉입체가 있는 거대 전적혈모구와 혈구세포를 탐식하는 조직구의 증가, 항Parvovirus B19 IgM 항체와 중합효소연쇄반응 양성소견으로 Parvovirus B19의 감염에 의한 혈구탐식림프조직구증으로 진단하였고, 스테로이드 및 IV immunoglobulin의 보존적 치료에 의해 회복된 증례를 보고하는 바이다.
Abstract
Hemophagocytic lymphohistiocytosis is an unusual syndrome that's characterized by fever, hepatosplenomegaly, cytopenias, hypertriglyceridemia, hypofibrinogenemia and pathologic finding of hemophagocytosis in the bone marrow and other tissues. A previously healthy 16-year-old male was admitted because of fever. The cervical and axillary lymph nodes, liver and spleen were palpable. CBC revealed pancytopenia with a decreased reticulocyte count, and the bone marrow aspiration smear showed the presence of giant pronormoblasts with intranuclear inclusion bodies and an increased number of histiocytes that were engulfing blood cell. IgM antibody against Parvovirus B19 and PCR for Parvovirus B19 were positive. Thus, he was diagnosed with hemophagocytic lymphohistiocytosis that was caused by Parvovirus B19 infection. Parvovirus B19 is an agent rarely associated with hemophagocytic lymphohistiocytosis, and in most cases it occurs in those patients with an underlying disease. We report here on a case of hemophagocytic lymphohistiocytosis associated with acute Parvovirus B19 infection in healthy male.(Korean J Med 72:433-436, 2007)
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