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연세대학교 의과대학 Yonsei Medical Journal Yonsei Medical Journal 제60권 제6호
발행연도
2019.1
수록면
592 - 596 (5page)

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Severe fever with thrombocytopenia syndrome (SFTS) is an emerging infectious zoonosis caused by the SFTS virus. Hemophagocyticlymphohistiocytosis (HLH) is a life-threatening syndrome associated with excessive immune activation. Cytokine stormsare often seen in both SFTS and HLH, resulting in rapid disease progression and poor prognosis. The aim of this study was toidentify whether SFTS cases complicated by HLH are related to higher rates of mortality. Descriptive analysis of the frequency ofclinical and laboratory data, complications, treatment outcomes, and HLH-2004 criteria was performed. Cases presenting withfive or more clinical or laboratory findings corresponding to the HLH-2004 diagnostic criteria were defined as SFTS cases complicatedby HLH. Eighteen cases of SFTS were identified during a 2-year study period, with a case-fatality proportion of 22.2% (4among 18 cases, 95% confidence interval 9%–45.2%). SFTS cases complicated by HLH were identified in 33.3% (6 among 18 cases). A mortality rate of 75% (3 among 4 cases) was recorded among SFTS cases complicated by HLH. Although there were no statisticallysignificant differences in outcomes, fatal cases exhibited more frequent correlation with HLH-2004 criteria than non-fatalcases [3/14 (21.4%) vs. 3/4 (75%), p=0.083]. In conclusion, the present study suggests the possibility that SFTS casescomplicated by HLH are at higher risk of poor prognosis.

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