A 19-year-old female was diagnosed with ulcerative colitis when she presented with persistent melena, and has been treated with 5-aminosalicylic acid for 4 years, with additional azathioprine for 2 years at our hospit...A 19-year-old female was diagnosed with ulcerative colitis when she presented with persistent melena, and has been treated with 5-aminosalicylic acid for 4 years, with additional azathioprine for 2 years at our hospital. The patient experienced high-grade fevers, chills, and cough fve d prior to presenting to the outpatient unit. At frst, the patient was suspected to have developed neutropenic fever; however, she was diagnosed with Epstein-Barr virus-associated hemophagocytic syndr-ome （EB-VAHS） upon fulfilling the diagnostic criteria after bone marrow aspiration. When patients withinflammatory bowel disease treated with immunomo-dulators, such as thiopurine preparations, develop fever, EB-VAHS should be considered in the differential diagnosis.展开更多
目的:分析EB病毒相关性噬血细胞综合征(EB virus-associated hemophagocytic syndrome,EBVAHS)患儿EB病毒潜伏膜蛋白1(latent membrane protein 1,LMP1)、辅助性T细胞1(helper T cell1,Th1)细胞因子的表达水平及其与疗效的关系。方法:...目的:分析EB病毒相关性噬血细胞综合征(EB virus-associated hemophagocytic syndrome,EBVAHS)患儿EB病毒潜伏膜蛋白1(latent membrane protein 1,LMP1)、辅助性T细胞1(helper T cell1,Th1)细胞因子的表达水平及其与疗效的关系。方法:抽取郑州大学附属儿童医院儿科2014年2月至2018年1月收治的116例EB病毒感染患儿为研究对象,分为单核细胞增多症(infect iousmononucleosis,IM)组与EBV-AHS组,其中IM 66例,EBV-AHS 50例。EBV-AHS组按照国际组织细胞协会推荐的HLH-2004方案给予治疗,于治疗4周后评定近期疗效。另选取同期体检的健康儿童30例作为对照组。对照组于体检时、IM组于确诊时、EBV-AHS组于治疗前、治疗后采血,检测血清LMP1抗体表达及Th1细胞因子水平。结果:与对照组相比,IM组和EBV-AHS组患儿确诊时血清LMP1抗体、白介素(IL)-2、干扰素(IFN)-γ及肿瘤坏死因子(TNF)-α水平显著增高,差异有统计学意义(P<0.05)。IM组和EBV-AHS组患儿血清LMP1抗体,IL-2,IFN-γ,TNF-α水平差异亦有统计学意义(P<0.05)。治疗后EBV-AHS组50例患儿中,疾病缓解者17例(34.00%),有效者22例(44.00%),余下11例(22.00%)疾病活动。疾病缓解者、有效者血清LMP1抗体,IL-2,IFN-γ,TNF-α水平明显较治疗前降低(P<0.05),而疾病活动者血清LMP1抗体,IL-2,IFN-γ,TNF-α水平较治疗前无明显改善(P>0.05);且疾病缓解者、有效者、疾病活动者血清LMP1抗体,IL-2,IFN-γ,TNF-α水平均依次升高,差异有统计学意义(P<0.05)。结论:EBV-AHS患儿血清LMP1抗体表达及Th1细胞因子水平较IM患儿及正常儿童显著升高,且其与疗效密切相关。展开更多
文摘A 19-year-old female was diagnosed with ulcerative colitis when she presented with persistent melena, and has been treated with 5-aminosalicylic acid for 4 years, with additional azathioprine for 2 years at our hospital. The patient experienced high-grade fevers, chills, and cough fve d prior to presenting to the outpatient unit. At frst, the patient was suspected to have developed neutropenic fever; however, she was diagnosed with Epstein-Barr virus-associated hemophagocytic syndr-ome （EB-VAHS） upon fulfilling the diagnostic criteria after bone marrow aspiration. When patients withinflammatory bowel disease treated with immunomo-dulators, such as thiopurine preparations, develop fever, EB-VAHS should be considered in the differential diagnosis.
