급성 골수세포백혈병에서 유도 항암화학요법 후에 발생한 적혈구포식성 림프조직구증식증 1예 (Hemophagocytic Lymphohistiocytosis Occurring after Induction Chemotherapy in Acute Myelocytic Leukemia)

서지정보

· 발행기관 : 대한내과학회
· 수록지 정보 : 대한내과학회지 / 91권 / 1호 / 79 ~ 83페이지
· 저자명 : 윤정아, 전민경, 강선명, 오은혜, 신승환, 김시찬, 이제환

초록

악성 종양과 관련한 HLH의 경우는 드물지만 매우 불량한예후를 보인다. 원인불명의 발열과 혈청 페리틴의 증가, 고중성지방혈증, 저피브리노겐혈증 등의 소견을 보일 경우HLH의 가능성을 의심하고 신속하게 골수 검사와 혈청학적검사를 시행하여 신속한 진단과 치료를 시행하는 것이 중요하겠다.

영어초록

Hemophagocytic lymphohistiocytosis (HLH), associated with acute myelocytic leukemia (AML), is a very rare disease. We here report a case of HLH occurring after induction chemotherapy for AML. AML-associated HLH can be triggered by AML itself, by chemotherapeutic agents, or by infectious complications. Our patient developed a high-grade fever of unknown cause, bilateral pulmonary infiltrates, and shock after successful treatment of AML with induction chemotherapy, and had high serum ferritin, hypertriglyceridemia, hypofibrinogenemia, hemophagocytic histiocytes in bone marrow, low natural killer cell activity, and elevated soluble interleukin-2 receptor levels. A diagnosis of HLH was made. Dexamethasone, cyclosporine, and etoposide were given and allogeneic hematopoietic stem cell transplantation was performed. Careful suspicion of HLH may be warranted if a patient experiences fever of unknown etiology, high ferritin levels, and liver dysfunction during AML treatment.

참고자료

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