急性髓系白血病相关Sweet综合征一例  

A Case of Sweet Syndrome Associated with Acute Myeloid Leukaemia

作　　者：毕延艳 辛苗苗[1] 罗园园 温大蔚 王茜[1] 孙明姝[1] 

机构地区：[1]青岛大学附属医院风湿免疫科,山东 青岛 [2]北京大学人民医院(青岛)风湿免疫科,山东 青岛

出　　处：《临床医学进展》2024年第12期923-927,共5页Advances in Clinical Medicine

摘　　要：目的:探讨急性髓系白血病相关急性发热性嗜中性皮病的临床特征及诊治。方法:报道1急性髓系白血病相关Sweet综合征分析其临床特点及诊疗经过,复习国内外相关文献。结果:62岁女性患者,因高热1月,皮肤红斑伴破溃半月住院,根据症状、辅助检验、皮肤学活检考虑为急性发热性嗜中性皮病,给予激素治疗后皮疹好转,出现血小板低,行骨髓穿刺见2%的原始细胞,患者拒绝再次骨髓穿刺,血液病诊断无法明确。出院后规律随诊,监测血小板计数均正常,给予激素控制皮疹。7月后,因发热及新发皮疹、四肢无力4天再次入院。因血小板低第二次骨髓穿刺:骨髓中见40.1%的异常髓系原始细胞群,表达MPO,考虑急性髓系白血病,化疗过程中患者很快出现急性重症肺炎(卡氏肺孢子虫感染),后继发多脏器衰竭死亡。结论:急性髓系白血病相关Sweet综合征患者长期使用激素免疫力低,对肿瘤原发病治疗的耐受性差,预后不佳。应尽早多次骨髓穿刺明确诊断,早期启动原发病的治疗。Objective: To investigate the clinical features and treatment of acute myeloid leukemia-associated acute febrile neutrophilic dermatosis. Methods: One case of acute myeloid leukemia-associated Sweet’s syndrome was reported, and its clinical features and diagnosis and treatment were analyzed, and the relevant domestic and foreign literature was reviewed. Results: A 62-year-old female patient was hospitalized with high fever for one month and erythema with broken skin for half a month. Based on the symptoms, auxiliary tests and dermatological biopsy, she was considered to have acute febrile neutrophilic dermatosis, and her rash improved after glucocorticoid treatment, low platelets were present, 2% of the original cells were found in bone marrow puncture, and the patient refused to repeat bone marrow puncture, so a definitive diagnosis could not be made. The patient was discharged from the hospital with regular fol

关 键 词：急性发热性嗜中性皮病 急性髓系白血病 糖皮质激素 

分 类 号：R73[医药卫生—肿瘤]