International Journal of Hematology

, Volume 79, Issue 4, pp 334–336 | Cite as

Tuberculosis-Associated Hemophagocytic Syndrome in a Hemodialysis Patient with Protracted Fever

  • Chih-Chiang Chien
  • Tzeon-Jye Chiou
  • Ming-Yang Lee
  • Liang-Tsai Hsiao
  • Wei-Kang Kwangb
Case Report


Hemophagocytic syndrome (HPS) is a clinicopathological reflection of uncontrolled activation of macrophages. To our knowledge, only a few cases of tuberculosis-associated HPS in hemodialysis have been reported in the English literature. We report a case of tuberculosis-associated HPS during hemodialysis. Bone marrow aspiration showed histiocytosis with hemophagocytosis; in addition, results of acid-fast staining and polymerase chain reaction showed the presence of acid-fast bacilli.Mycobacterium tuberculosis was subsequently cultured from sputum. The patient received late treatment with antituberculosis agents combined with intravenous immunoglobulin and had a poor response. On the basis of the results in this case, we recommend early bone marrow and tuberculous examination for patients undergoing maintenance hemodialysis who have fever of unknown origin.

Key words

Hemophagocytic syndrome Hemodialysis Fever of unknown origin 


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Copyright information

© The Japanese Society of Hematology 2004

Authors and Affiliations

  • Chih-Chiang Chien
    • 1
  • Tzeon-Jye Chiou
    • 1
  • Ming-Yang Lee
    • 1
  • Liang-Tsai Hsiao
    • 1
  • Wei-Kang Kwangb
    • 2
  1. 1.Division of Medical Oncology, Department of MedicineTaipei Veterans General Hospital and National Yang-Ming UniversityTaipeiTaiwan
  2. 2.Department of PathologyTaipei Veterans General Hospital and National Yang-Ming UniversityTaipeiTaiwan

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