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( Ganis Irawan ),( M Riswan ),( Krishna Sucipto ),( Hendra Zufry ),( Desi Salwani ),( Muslim ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1
Hemophagocytic syndrome (HPS) is a rare, life-threatening, hematologic disorder which might arises secondary to infection, autoimmune disease or malignancy. It is most often characterized by prolonged fever, splenomegaly, and cytopenia of at least two lineages. Splenic tuberculosis is a rare form of extrapulmonary tuberculosis. No particular set of clinical symptoms or imaging findings is characteristic for splenic tuberculosis. We are reporting a case of HPS associated with splenic tuberculosis in 36 year old male who was admitted to our hospital due to persistent fever for the past 3months. He complained of distended belly, weakness, night sweats and weight loss. He lives in a rural village which is known to be an endemic area of malaria and tuberculosis. Histopathological examination of spleen tissue supported the diagnosis of splenic tuberculosis. Diagnosis of HPS were established by the presence of fever, splenomegaly, pancytopenia, hypofi brinogenemia and serum ferritin level more than 500 μg/l. Additional supportive evidences were hepatomegaly, elevated lactate dehydrogenase and slightly-hypoplastic marrow.
( Ganis Irawan ),( Wira Idiawaty ),( Teuku Mamfaluti ),( Mahriani Sylvawani ),( Fauzi Yusuf ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1
Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) is a disorder associated with various drugs and characterized by cutaneous drug eruption, eosinophilia and systemic symptoms. The diagnosis poses diffi culties due to its heterogeneity and long latency period. We report a case of 25 year old male with medical history significant for stage four chronic kidney disease, recently started on allopurinol for hyperuricemia, presented with fever, generalized exfoliative dermatitis and jaundice. Laboratory examination revealed hypereosinophilia, hyperuricemia, elevated bilirubin and elevated liver enzymes. Magnetic resonance imaging revealed acalculous cholecysititis and gallbladder hydrops. He was successfully treated with oral methylprednisolone and bepotastine.