Low interleukin-10 level indicates a good prognosis in Salmonella enterica serovar typhimurium-induced pediatric hemophagocytic lymphohistiocytosis:A case report  

作　　者：Yuan-Yuan Chen Xiang-Zhi Xu Xiao-Jun Xu 

机构地区：[1]Division/Center of Pediatric Hematology Oncology,Children’s Hospital,Zhejiang University School of Medicine,Hangzhou 310003,Zhejiang Province,China [2]Pediatric Intensive Care Unit,Children’s Hospital of Zhejiang University School of Medicine,Hangzhou 310003,Zhejiang Province,China

出　　处：《World Journal of Clinical Cases》2024年第9期1660-1668,共9页世界临床病例杂志

基　　金：Supported by Zhejiang Province Health and Wellness Science and Technology Program in 2022,China,No.2022RC202.

摘　　要：BACKGROUND Secondary hemophagocytic lymphohistiocytosis(sHLH)triggered by Salmonella enterica serovar Typhimurium is rare in pediatric patients.There is no consensus on how to treat S.typhimurium-triggered sHLH.CASE SUMMARY A 9-year-old boy with intermittent fever for 3 d presented to our hospital with positive results for S.typhimurium,human rhinovirus,and Mycoplasma pneumoniae infections.At the time of admission to our institution,the patient’s T helper 1/T helper 2 cytokine levels were 326 pg/mL for interleukin 6(IL-6),9.1 pg/mL for IL-10,and 246.7 pg/mL for interferon-gamma(IFN-γ),for which the ratio of IL-10 to IFN-γwas 0.04.In this study,the patient received meropenem,linezolid,and cefoperazone/sulbactam in combination with high-dose methylprednisolone therapy(10 mg/kg/d for 3 d)and antishock supportive treatment twice.After careful evaluation,this patient did not receive HLH chemotherapy and recovered well.CONCLUSION S.Typhimurium infection-triggered sHLH patient had a ratio of IL-10 to IFN-γ≤1.33,an IL-10 concentration≤10.0 pg/mL,and/or an IFN-γconcentration≤225 pg/mL at admission.Early antimicrobial and supportive treatment was sufficient,and the HLH-94/2004 protocol was not necessary under these conditions.

关 键 词：Hemophagocytic lymphohistiocytosis Cytokine pattern Interferon gamma INTERLEUKIN-10 Salmonella enterica serovar Typhimurium Case report 

分 类 号：R596[医药卫生—内科学] R541.7[医药卫生—临床医学]