以长期发热为特点的慢性粒单核细胞白血病合并Sweet综合征1例  

Chronic fever-characterized chronic myelomonocytic leukemia accompanying Sweet's syndrome: A case report

作　　者：刘昕[1] 张志强[1] 翟永志[1] 陈歆[1] 缪媛媛[1] 赵春洪[1] 肖红菊[1] 刘刚[1] 

机构地区：[1]解放军总医院发热疾病科FUO研究小组,北京100853

出　　处：《解放军医学院学报》2013年第11期1128-1130,1134,共4页Academic Journal of Chinese PLA Medical School

基　　金：国家科技重大专项(2013ZX1004805-003);解放军总医院临床科研扶持基金(2012FC-TSYS-3033)~~

摘　　要：目的提高不明原因发热(fever of unknown origin,FUO)病因诊断中对慢性粒单核细胞白血病(chronic myelomonocytic leukemia,CMML)的认识,探讨CMML临床特点,Sweet综合征(Sweet's syndrome,SS)与CMML的关系。方法回顾1例以不明原因发热就诊,合并SS,最后确诊为CMML青年男性患者的临床资料并复习相关文献。结果患者长期发热,病程中出现痛性皮疹,皮肤活检示中性粒细胞浸润符合SS。肺CT示肺部感染,巨细胞病毒COPY阳性,外周血单核细胞计数持续高于1.0×109/L,骨髓形态可见2系病态造血,先后诊断为SS合并肺炎,巨细胞病毒感染等,抗感染及激素治疗无效,并除外其他引起单核细胞计数高的疾病后诊断为CMML。结论 CMML临床症状可有长期发热,SS可为CMML前驱症状。Objective To improve our understanding of chronic myelomonocytic leukemia （CMML） in etiological diagnosis of fever of unknown origin （FUO） and to study the clinical characteristics of CMML and the relation between Sweet’s syndrome （SS） and CMML. Methods Clinical data about 1 patient with FUO accompanying SS were retrospectively analyzed with its relevant literature reviewed. Results The patient suffered from chronic fever with painful skin rashes. Laboratory test showed that the number of peripheral mononuclear cells was 〉 1.0 × 10^9 /L and bone marrow morphology revealed pathological hematopoietic cells. The patient who was diagnosed with SS accompanying pneumonia and cytomegalovirus infection had no response to anti-infection and hormone therapy. After other causes that increased the number of mononuclear cells were excluded, the patient was finally diagnosed with CMML. Conclusion CMML is manifested as chronic fever with SS as its precursory symptom.

关 键 词：不明原因发热 慢性粒单核细胞白血病 SWEET综合征 

分 类 号：R447[医药卫生—诊断学]