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A successful treatment of severe systemic lupus erythematosus caused by occult pulmonary infection-associated with hemophagocytic syndrome: A case report.

Abstract A 27-year-old woman with a history of systemic lupus erythaematosus (SLE) developed hemophagocytic syndrome (HPS) secondary due to an unrecognized infection that led to severe SLE with a prolonged recovery.
PMID
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Authors

Mayor MeshTerms

Lupus Erythematosus, Systemic

Lymphohistiocytosis, Hemophagocytic

Pneumonia

Keywords
Journal Title medicine
Publication Year Start




PMID- 29742693
OWN - NLM
STAT- MEDLINE
DCOM- 20180515
LR  - 20180515
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Linking)
VI  - 97
IP  - 19
DP  - 2018 May
TI  - A successful treatment of severe systemic lupus erythematosus caused by occult
      pulmonary infection-associated with hemophagocytic syndrome: A case report.
PG  - e0595
LID - 10.1097/MD.0000000000010595 [doi]
AB  - RATIONALE: A 27-year-old woman with a history of systemic lupus erythaematosus
      (SLE) developed hemophagocytic syndrome (HPS) secondary due to an unrecognized
      infection that led to severe SLE with a prolonged recovery. PATIENT CONCERNS: The
      patient showed a high spiking fever and myalgia. Laboratory data revealed
      pancytopenia and immunological abnormalities. Pulse methylprednisone plus
      intravenous immunoglobulin (IVIG) failed to improve the clinical symptoms and
      laboratory data. DIAGNOSES: As activated macrophages with hemophagocytosis were
      confirmed in bone marrow histology, the patient was diagnosed as having reactive 
      HPS. INTERVENTIONS AND OUTCOMES: Her reactive HPS was successfully treated with
      intravenous antibiotics and was followed by oral prednisolone and
      hydroxychloroquine maintenance therapy. LESSONS: In severe SLE, patients with
      persistent high fever, cytopenia, and elevated levels of serum ferritin and liver
      enzymes should be strongly suspected of reactive HPS, and aggressive examination,
      such as bone marrow biopsy, needs to be considered for early diagnosis and proper
      treatment.
FAU - Shi, Weihong
AU  - Shi W
AD  - Department of Chinese Medicine, Guangzhou General Hospital of Guangzhou Military 
      Command.
AD  - Guangzhou University of Chinese Medicine, Guangzhou, China.
FAU - Duan, Mingyang
AU  - Duan M
AD  - Guangzhou University of Chinese Medicine, Guangzhou, China.
FAU - Jie, Ligang
AU  - Jie L
AD  - Department of Chinese Medicine, Guangzhou General Hospital of Guangzhou Military 
      Command.
FAU - Sun, Weifeng
AU  - Sun W
AD  - Department of Chinese Medicine, Guangzhou General Hospital of Guangzhou Military 
      Command.
LA  - eng
PT  - Case Reports
PT  - Journal Article
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
RN  - 0 (Anti-Bacterial Agents)
RN  - 0 (Antirheumatic Agents)
RN  - 141A6AMN38 (Cilastatin)
RN  - 4QWG6N8QKH (Hydroxychloroquine)
RN  - 71OTZ9ZE0A (Imipenem)
RN  - 9PHQ9Y1OLM (Prednisolone)
SB  - AIM
SB  - IM
MH  - Adult
MH  - Anti-Bacterial Agents/administration & dosage
MH  - Antirheumatic Agents/administration & dosage
MH  - Blood Cell Count/methods
MH  - Bone Marrow Examination/methods
MH  - Cilastatin/*administration & dosage
MH  - Female
MH  - Humans
MH  - Hydroxychloroquine/*administration & dosage
MH  - Imipenem/*administration & dosage
MH  - Lung/*diagnostic imaging
MH  - *Lupus Erythematosus, Systemic/complications/diagnosis/drug therapy
MH  - *Lymphohistiocytosis, Hemophagocytic/diagnosis/drug therapy/etiology/immunology
MH  - *Pneumonia/complications/diagnosis/drug therapy/immunology
MH  - Prednisolone/*administration & dosage
MH  - Tomography, X-Ray Computed/methods
MH  - Treatment Outcome
EDAT- 2018/05/10 06:00
MHDA- 2018/05/16 06:00
CRDT- 2018/05/10 06:00
PHST- 2018/05/10 06:00 [entrez]
PHST- 2018/05/10 06:00 [pubmed]
PHST- 2018/05/16 06:00 [medline]
AID - 10.1097/MD.0000000000010595 [doi]
AID - 00005792-201805110-00012 [pii]
PST - ppublish
SO  - Medicine (Baltimore). 2018 May;97(19):e0595. doi: 10.1097/MD.0000000000010595.