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Fatal case of TAFRO syndrome associated with over-immunosuppression: a case report and review of the literature
https://doi.org/10.18999/nagjms.81.3.519
https://doi.org/10.18999/nagjms.81.3.5195982bddf-690f-4a6e-a99b-441dcee7eacc
名前 / ファイル | ライセンス | アクション |
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Item type | 紀要論文 / Departmental Bulletin Paper(1) | |||||
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公開日 | 2019-09-04 | |||||
タイトル | ||||||
タイトル | Fatal case of TAFRO syndrome associated with over-immunosuppression: a case report and review of the literature | |||||
著者 |
Matsuhisa, Takaharu
× Matsuhisa, Takaharu× Takahashi, Noriyuki× Nakaguro, Masato× Sato, Motoki× Inoue, Eri× Teshigawara, Shiho× Ozawa, Yukihiro× Kondo, Takeshi× Nakamura, Shigeo× Sato, Juichi× Ban, Nobutaro |
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キーワード | ||||||
主題Scheme | Other | |||||
主題 | TAFRO syndrome | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | immunosuppression | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | course of treatment | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | disseminated candidiasis | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | hemophagocytic lymphohistiocytosis | |||||
抄録 | ||||||
内容記述 | TAFRO syndrome is a novel disease concept characterized by Thrombocytopenia, Anasarca, myelo-Fibrosis, Renal dysfunction, Organomegaly, multiple lymphadenopathy and a histopathological pattern of atypical Castleman’s disease. A 58-year-old man was diagnosed as TAFRO syndrome by clinical and histopathological findings. After receiving intensive immunosuppressive therapy, his thrombocytopenia and anasarca had not improved. He developed complications such as methicillin-resistant Staphylococcus aureus sepsis, gastrointestinal bleeding, peritonitis caused by Stenotrophomonas maltophilia, gastrointestinal perforation, and disseminated candidiasis resulting in death. Autopsy revealed disseminated candidiasis and hemophagocytic lymphohistiocytosis, with no evidence of TAFRO syndrome. During treatment, we regarded his lasting thrombocytopenia and anasarca as insufficient control of TAFRO syndrome. However, the autopsy revealed that thrombocytopenia was caused by secondary hemophagocytic lymphohistiocytosis caused by over-immunosuppression. We reviewed the published literature to identify indicators of adequate treatment, which suggested improvement of platelet count and anasarca several weeks after initial therapy. This indicated that we could not depend on the platelet count and anasarca in acute medical care after initial treatment. We should treat TAFRO syndrome based on patients’ clinical status and obviate the risk of treatment-related complications caused by over-immunosuppression. | |||||
内容記述タイプ | Abstract | |||||
出版者 | ||||||
出版者 | Nagoya University Graduate School of Medicine, School of Medicine | |||||
言語 | ||||||
言語 | eng | |||||
資源タイプ | ||||||
資源 | http://purl.org/coar/resource_type/c_6501 | |||||
タイプ | departmental bulletin paper | |||||
ID登録 | ||||||
ID登録 | 10.18999/nagjms.81.3.519 | |||||
ID登録タイプ | JaLC | |||||
関連情報 | ||||||
関連タイプ | isVersionOf | |||||
識別子タイプ | URI | |||||
関連識別子 | http://www.med.nagoya-u.ac.jp/medlib/nagoya_j_med_sci/813.html | |||||
ISSN(print) | ||||||
収録物識別子タイプ | ISSN | |||||
収録物識別子 | 0027-7622 | |||||
ISSN(Online) | ||||||
収録物識別子タイプ | ISSN | |||||
収録物識別子 | 2186-3326 | |||||
書誌情報 |
Nagoya Journal of Medical Science 巻 81, 号 3, p. 519-528, 発行日 2019-08 |
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著者版フラグ | ||||||
値 | publisher |