类风湿性关节炎暴发噬血细胞综合征1例的临床形态学谱  

Clinical morphological spectrum of 1 case of rheumatoid arthritis outbreak of hemophagocytic syndrome

作　　者：张成林 李芬 王清亮 甘丽媛 ZHANG Chenglin;LI Fen;WANG Qingliang;GAN Liyuan(Department of Clinical Laboratory,Chongqing Sanbo Changan Hospital,Chongqing 400023,China;Department of Pathology,Chongqing Sanbo Changan Hospital,Chongqing 400023,China;Department of Hematology,Chongqing Sanbo Changan Hospital,Chongqing 400023,China)

机构地区：[1]重庆三博长安医院检验科,重庆400023 [2]重庆三博长安医院病理科,重庆400023 [3]重庆三博长安医院血液科,重庆400023

出　　处：《现代医药卫生》2024年第12期2013-2017,共5页Journal of Modern Medicine & Health

摘　　要：目的 通过识别噬血细胞综合征(HLH)的临床病理特征,结合探讨类风湿性关节炎(RA)暴发HLH的发病机制,以期提高对该类疾病的早期鉴别。方法 将1例RA患者的临床、生化和其他生物学参数与骨髓中的发现相关联,以巨噬细胞的免疫组织化学标志物(CD68)标记骨髓活检中的噬血细胞活性,回顾性分析该患者HLH诊断标准中的各个参数。结果 患者符合HLH-2004的诊断标准,而临床病理成为该病早期识别的显著支撑依据。结论 对疑似HLH患者的骨髓进行彻底和仔细的筛查,对于早期鉴别诊断和及时治疗至关重要,而使用IHC标志物CD68来标记活检中的巨噬细胞有助于协助细胞检查的灵敏度。Objective By identifying the clinicopathological features of hemophagocytic syndrome(HLH),combined with the pathogenesis of rheumatoid arthritis(RA)outbreak of hemophagocytic syndrome,in order to improve the early identification of this disease.Methods The clinical,biochemical and other biological parameters of a RA patient were correlated with the findings in bone marrow.The activity of hemophagocytic cells in bone marrow biopsy was labeled with the immunohistochemical marker of macrophages(CD68).The parameters in the HLH diagnostic criteria of the patient were retrospectively analyzed.Results The patients met the diagnostic criteria of HLH-2004,and clinical pathology became a significant support for the early identification of the disease.Conclusion A thorough and careful screening of bone marrow in patients with suspected HLH is essential for early differential diagnosis and timely treatment.The use of the IHC marker CD68 to label macrophages in biopsyhelps to assist the sensitivity of cell examination.

关 键 词：骨髓活检 噬血性淋巴组织细胞增多症 噬血细胞综合征 类风湿性关节炎 免疫组化染色CD68 

分 类 号：R446.8[医药卫生—诊断学]