Introduction: Macrophage activation syndrome (SAM) results from inappropriate activation of macrophages in the bone marrow and lymphoid organs, responsible for hemaphagocytosis. It is a clinicopathological entity characterized by an excessive and uncontrolled inflammatory response that can be life-threatening. We report the case of macrophage activation syndrome complicating pleuropulmonary tuberculosis. Observation: this is the case of a 36-year-old patient, with antimalarial vaccination against malaria for a trip to the endemic area, who presents himself 4 days after his vaccination, in a table of asthenia and NYHA stage III dyspnea. the clinical examination found a conscious patient GCS 15/15, generally impaired, tachycardia at 125bpm, hypotensive at 85 / 32 mmHg, tachypneic at 36 cpm, with SpO2 at 87% in the open air, biologically: normal normocytic anemia at 8.4 g / dl, thrombocytopenia at 26000 / ul, leukocytosis at 34350 / ul, hyponatraemia at 123 mmol / l, hyperkalaemia at 6.26 mmol / l, uremia: 2.1g / l, cratininemia: 54 mg / l, Hepatic cytolysis with ASAT 3 times normal and ALAT 4 times normal, management consisted in admission to intensive care unit evolution was pejorative within the 24 hours of admission, by the installation of a state of refractory septic shock, The post-mortem myelogram confirmed macrophage activation. Discussion: The incidence of SAM is poorly known and its frequency is underestimated. A rare disease, the diagnosis of which is often delayed, especially in rapidly developing patients. The diagnosis remains an emergency for the care that remains non-consensual. Conclusion: SAM is a rare and poorly described clinical situation but unfortunately a source of wandering and delayed diagnosis. Rare, severe and often unrecognized can compromise life expectancy. The aim of the treatment is to control the macrophage reaction.
| Published in | International Journal of Anesthesia and Clinical Medicine (Volume 8, Issue 1) |
| DOI | 10.11648/j.ijacm.20200801.13 |
| Page(s) | 11-13 |
| Creative Commons |
This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited. |
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Copyright © The Author(s), 2020. Published by Science Publishing Group |
Macrophage Activation Syndrome, Hemophagocytosis, Vaccination Antimalarial
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APA Style
Zakaria Abjaw, Reda El Hadrami, Houssam Eddine Sahraoui, Hamza El Hamzaoui, Taoufik Abouelhassan, et al. (2020). About a Case, Macrophagic Activation Syndrome Post Vaccination. International Journal of Anesthesia and Clinical Medicine, 8(1), 11-13. https://doi.org/10.11648/j.ijacm.20200801.13
ACS Style
Zakaria Abjaw; Reda El Hadrami; Houssam Eddine Sahraoui; Hamza El Hamzaoui; Taoufik Abouelhassan, et al. About a Case, Macrophagic Activation Syndrome Post Vaccination. Int. J. Anesth. Clin. Med. 2020, 8(1), 11-13. doi: 10.11648/j.ijacm.20200801.13
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author = {Zakaria Abjaw and Reda El Hadrami and Houssam Eddine Sahraoui and Hamza El Hamzaoui and Taoufik Abouelhassan and Ghita Beddou and Hicham Yahyaoui and Imane Benjelloun and Mustapha Ait Ameur and Mohamed Chakour},
title = {About a Case, Macrophagic Activation Syndrome Post Vaccination},
journal = {International Journal of Anesthesia and Clinical Medicine},
volume = {8},
number = {1},
pages = {11-13},
doi = {10.11648/j.ijacm.20200801.13},
url = {https://doi.org/10.11648/j.ijacm.20200801.13},
eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijacm.20200801.13},
abstract = {Introduction: Macrophage activation syndrome (SAM) results from inappropriate activation of macrophages in the bone marrow and lymphoid organs, responsible for hemaphagocytosis. It is a clinicopathological entity characterized by an excessive and uncontrolled inflammatory response that can be life-threatening. We report the case of macrophage activation syndrome complicating pleuropulmonary tuberculosis. Observation: this is the case of a 36-year-old patient, with antimalarial vaccination against malaria for a trip to the endemic area, who presents himself 4 days after his vaccination, in a table of asthenia and NYHA stage III dyspnea. the clinical examination found a conscious patient GCS 15/15, generally impaired, tachycardia at 125bpm, hypotensive at 85 / 32 mmHg, tachypneic at 36 cpm, with SpO2 at 87% in the open air, biologically: normal normocytic anemia at 8.4 g / dl, thrombocytopenia at 26000 / ul, leukocytosis at 34350 / ul, hyponatraemia at 123 mmol / l, hyperkalaemia at 6.26 mmol / l, uremia: 2.1g / l, cratininemia: 54 mg / l, Hepatic cytolysis with ASAT 3 times normal and ALAT 4 times normal, management consisted in admission to intensive care unit evolution was pejorative within the 24 hours of admission, by the installation of a state of refractory septic shock, The post-mortem myelogram confirmed macrophage activation. Discussion: The incidence of SAM is poorly known and its frequency is underestimated. A rare disease, the diagnosis of which is often delayed, especially in rapidly developing patients. The diagnosis remains an emergency for the care that remains non-consensual. Conclusion: SAM is a rare and poorly described clinical situation but unfortunately a source of wandering and delayed diagnosis. Rare, severe and often unrecognized can compromise life expectancy. The aim of the treatment is to control the macrophage reaction.},
year = {2020}
}
TY - JOUR T1 - About a Case, Macrophagic Activation Syndrome Post Vaccination AU - Zakaria Abjaw AU - Reda El Hadrami AU - Houssam Eddine Sahraoui AU - Hamza El Hamzaoui AU - Taoufik Abouelhassan AU - Ghita Beddou AU - Hicham Yahyaoui AU - Imane Benjelloun AU - Mustapha Ait Ameur AU - Mohamed Chakour Y1 - 2020/03/17 PY - 2020 N1 - https://doi.org/10.11648/j.ijacm.20200801.13 DO - 10.11648/j.ijacm.20200801.13 T2 - International Journal of Anesthesia and Clinical Medicine JF - International Journal of Anesthesia and Clinical Medicine JO - International Journal of Anesthesia and Clinical Medicine SP - 11 EP - 13 PB - Science Publishing Group SN - 2997-2698 UR - https://doi.org/10.11648/j.ijacm.20200801.13 AB - Introduction: Macrophage activation syndrome (SAM) results from inappropriate activation of macrophages in the bone marrow and lymphoid organs, responsible for hemaphagocytosis. It is a clinicopathological entity characterized by an excessive and uncontrolled inflammatory response that can be life-threatening. We report the case of macrophage activation syndrome complicating pleuropulmonary tuberculosis. Observation: this is the case of a 36-year-old patient, with antimalarial vaccination against malaria for a trip to the endemic area, who presents himself 4 days after his vaccination, in a table of asthenia and NYHA stage III dyspnea. the clinical examination found a conscious patient GCS 15/15, generally impaired, tachycardia at 125bpm, hypotensive at 85 / 32 mmHg, tachypneic at 36 cpm, with SpO2 at 87% in the open air, biologically: normal normocytic anemia at 8.4 g / dl, thrombocytopenia at 26000 / ul, leukocytosis at 34350 / ul, hyponatraemia at 123 mmol / l, hyperkalaemia at 6.26 mmol / l, uremia: 2.1g / l, cratininemia: 54 mg / l, Hepatic cytolysis with ASAT 3 times normal and ALAT 4 times normal, management consisted in admission to intensive care unit evolution was pejorative within the 24 hours of admission, by the installation of a state of refractory septic shock, The post-mortem myelogram confirmed macrophage activation. Discussion: The incidence of SAM is poorly known and its frequency is underestimated. A rare disease, the diagnosis of which is often delayed, especially in rapidly developing patients. The diagnosis remains an emergency for the care that remains non-consensual. Conclusion: SAM is a rare and poorly described clinical situation but unfortunately a source of wandering and delayed diagnosis. Rare, severe and often unrecognized can compromise life expectancy. The aim of the treatment is to control the macrophage reaction. VL - 8 IS - 1 ER -
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