Abstract：Objective: To investigate the clinical features and treatment experience of children with tsutsugamushi disease complicated with hemophagocytic lymphohistiocytosis (HLH). Methods: The epidemiology, general data, clinical manifestations, laboratory results, treatment and outcome of 8 cases of tsutsugamushi disease with HLH in our hospital from January 2014 to December 2020 were analyzed retrospectively. Results: All 8 children with tsutsugamushi disease met the diagnostic criteria of HLH. Eight cases were accompanied by varying degrees of abnormal transaminase, abnormal myocardial zymogram, hypoproteinemia and the proportion of CD4+ decreased significantly; 5 cases were accompanied by lacunar effusion and 3 cases were accompanied by abnormal cerebrospinal fluid. 7 of the cases were given doxycycline anti infection, IVIG combined with glucocorticoid and other supportive treatment in the early stage. 1 of the cases was given dexamethasone + etoposide induction chemotherapy in the early stage, and doxycycline was added to anti infection after the diagnosis of tsutsugamushi disease. The indexes of peripheral blood, liver function, myocardial enzyme spectrum of 8 cases were significantly improved, the liver and spleen were shrunk, and hemophagocytosis disappeared. No doxycycline related adverse reactions or hematologic diseases were found in the short-term follow-up. Conclusion: HLH is a rare complication of tsutsugamushi disease, which can be associated with multiple organ injuries. Effective anti-infection and combined treatment with IVIG and glucocorticoid can effectively alleviate HLH while chemotherapy may be not necessary.
李鑫, 谭力, 李明, 吕瑜, 张婷. 恙虫病继发噬血细胞性淋巴组织细胞增多症8例临床分析[J]. 河北医学, 2022, 28(2): 314-318.
LI Xin, TAN Li, LI Ming, et al. Clinical Analysis of 8 Cases of Hemophagocytic Lymphohistiocytosis Secondary to Tsutsugamushi Disease. HeBei Med, 2022, 28(2): 314-318.
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2022, Vol. 28 
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