MACROPHAGE ACTIVATION SYNDROME IN A PATIENT WITH SEPSIS DUE TO STREPTOCOCCUS PNEUMONIAE
Abstract:
Macrophage activation syndrome (MAS) is characterized by an acute systemic inflammation, caused by a “cytokine storm”. Most frequently, it is a deadly complication of a rheumatic disease and the pathogenity consists of an expansion and activation of CD8+T lymphocytes and macrophages with hemophagocytic activity. This massive hyperinflammatory status is associated with three cardinal signs: cytopenia, liver dysfunction and coagulopathy. The diagnostic approach in early stages is often difficult and is only based on a molecular diagnosis or when 5 of 8 HLH-2004 criteria are met. From the two types of macrophage activation syndrome (familial/reactive), we report the case of a splenectomized patient with a secondary type of MAS, reactive to sepsis due to S. pneumonia. Further on, we assert our diagnostic approach based on clinical and laboratory criteria, presented in dynamics. Last but not least, we relate our “modus operandi” in the Intensive Care Unit management of the patient.
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