Experts in exhorting health to take into account this type of team as differential diagnosis
Belinda Zorielie Burgos González
Agencia Latina de Noticias Medicina y Salud Pública
The doctors prescribe a clinical setting for sepsis. Persistence and insistence on regular treatments for the drug that occurs in the patient’s immune system. But, this immunology tends to be a tramp.
And it is that hemophagocytic linfohistiocitosis syndrome (HLH, by its signs in English) demonstrates that not only can sepsis be caused by an inflammatory inflammation of the system immune to a viral cyst, but also can the cambium respond to it the patient is treated and can be treated.
The HLH is not an affection, it is a small group of afflictions that provoke that the humanitarian system works adequately. Patients who develop this free-flowing cytokine syndrome, which provokes the accumulation of activated cellular cells that give rise to parts of the body such as: the higado, the base, the oceanic medium and the brain. If the treatment is adequate, it can cause serious deaths to the organs and death.
These are the main types of HLH. A type is called HLH “known” (or the primary), which means it can transmit generation after generation. The second type is called HLH “acquired” (or secondary), which results in specific infections, cancers and autoimmune diseases that usually produce in both major and adult children.
It is known that genes also play an important role in the appearance of the syndrome, as is its PRF1, UNC13D, STX11 y STXBP2. It is believed that the mutations in these genes can cause an increase in 60 to 70% of HLH cases.
On the other hand, sepsis is caused by a reproductive response to an infection, which can not be treated until it is dead.
José Manuel Ayala Torres, Head of Residence at La Concepción Hospital, researched ‘Med Medicina y Salud Pública (MSP)’s case of a 56-year-old man diagnosed with hypertension and psoriasis, who was admitted to the emergency room. fever, vomiting, headache, dizziness, sciatica, among other syndromes.
Physically, the patient is aggravated by illness, lethargy, tenaciousness and his pressures are bad, for which the fasting doctors think that a clinical clinic can treat “a sepsis disorder with viral algae”.
When the laboratory laboratories perform with marginal white blood cells, thrombocytopenia, anemia, and levels of lactate (lactic acid) normal. If it begins to treat the patient with fluids, if the antibiotic is venous, if it is cultivated, placed, among other things. Empezamos have seen complications complicating the first hour of treatment for sepsis, and we see that it has a nodule in the pulses of 6 millimeters in the superior lobe of the esophagus, multiple nodules in the lower part of the pulmonary, mediocre mesodus increased, between other syndromes in the area of the pulmonums ”, said Ayala Torres.
“We all have the treatment we receive for the patient we treat as sepsis, no response (the patient). Commence to perform its respiratory function and require mechanical ventilation. The levels of hemoglobin and plaques are drastically reduced. We will implement another type of HIV-positive test and treatment, with the apparent presentation of sepsis severely. We consulted the case with a hematologist, and without thinking twice, diagnosed that everything was treated by a secondary HLH ”, afirmó el especialista. From the doctor, a date that surprises because the patient has no historical history of the syndrome, on the contrary, what powder can be experienced in this type of syndrome.
El Dr. Ayala Torres, as a specialist on the topic of pointing out that the VIH patient’s positive diagnosis can provoke the predisposition of this patient to the secondary HLH.
The Doctor stated that for the year 2004, diagnostic criteria were established to support the HLH, between the figures figured fever persisting on these days or more, esplenomegalia (increase of base), citopenia “in more than two lines” number normaal), en renglones bajos ya sea plaquetas y hemoglobina o globlos blancos bajos y plaquetas bajas.
The high levels of triglycerides and the presentation of hemophagocytosis (proliferation of histiocytes or immune cells) also constitute part of the clinical criteria for susceptibility to HLH syndrome, indico.
“This is a very interesting case for every internist. “I understand that many of the cases that are treated as ‘septic shock’ and no better with the treatment given, treat the syndrome of secondary hemophagocytic hemophagocytic syndrome that has never been diagnosed”, said Dr. Ayala Torres.
“It is very rare that this HLH secondary syndrome occurs in adults. When reviewed in the literature all the cases described by HLH are nines that are usually seen by dengue. This powder is the first case that is seen in adult syndrome specifically described in Puerto Rico, ”he assured.
Finally, the patient needs the treatment based on anti-inflammatory and anti-inflammatory drugs and can recover.
Among the authors of the case were also the doctors Miguel Meléndez, Luis Negrón, Yussef FIol-Galib, Amaury Segarra, Doris Iturrino and José Rivera Ramírez.