Adult haemophagocytic syndrome

被引:1147
作者
Ramos-Casals, Manuel [1 ]
Brito-Zeron, Pilar [1 ]
Lopez-Guillermo, Armando [3 ]
Khamashta, Munther A. [4 ]
Bosch, Xavier [2 ]
机构
[1] Univ Barcelona, IDIBAPS, Hosp Clin,Josep Font Lab Autoimmune Dis CELLEX, Dept Autoimmune Dis,Inst Clin Med & Dermatol, E-08036 Barcelona, Spain
[2] Univ Barcelona, IDIBAPS, Hosp Clin, Dept Internal Med,Inst Clin Med & Dermatol, E-08036 Barcelona, Spain
[3] Univ Barcelona, IDIBAPS, Hosp Clin, Dept Haematol,Inst Clin Malalties Hematol & Oncol, E-08036 Barcelona, Spain
[4] Kings Coll Univ, St Thomas Hosp, Rayne Inst, Lupus Res Unit, London, England
关键词
EPSTEIN-BARR-VIRUS; RENAL-TRANSPLANT RECIPIENTS; B-CELL LYMPHOMA; DISSEMINATED INTRAVASCULAR COAGULATION; SYSTEMIC-LUPUS-ERYTHEMATOSUS; ACTIVATED FACTOR-VII; BONE-MARROW; CLINICAL-FEATURES; INTRAVENOUS IMMUNOGLOBULIN; CYCLOSPORINE-A;
D O I
10.1016/S0140-6736(13)61048-X
中图分类号
R5 [内科学];
学科分类号
100201 [内科学];
摘要
Haemophagocytic syndromes (haemophagocytic lymphohistiocytosis) have a wide range of causes, symptoms, and outcomes, but all lead to a hyperinflammatory response and organ damage-mainly reported in paediatric patients, but reports of adult presentation are increasing. Analysis of the genetic and molecular pathophysiology of these syndromes have improved the understanding of the crosstalk between lymphocytes and histiocytes and their regulatoty mechanisms. Clinical presentations with a broad differential diagnosis, and often life-threatening outcome, complicate the management, which might include supportive intensive care, immunosuppressive and biological treatments, or haemopoietic stem cell transplantation. Insufficient knowledge of these syndromes could contribute to poor prognosis. Early diagnosis is essential to initiate appropriate treatment and improve the quality of life and survival of patients with this challenging disorder.
引用
收藏
页码:1503 / 1516
页数:14
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