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Médecine et Santé Tropicales

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Syndrome d’activation macrophagique secondaire à une tuberculose pulmonaire cavitaire Volume 22, numéro 1, Janvier-Février-Mars 2012

Auteurs
Unité de soins, de formation et de recherches (USFR) de pneumologie,, de Rhumatologie, Centre hospitalier universitaire Joseph-Raseta-de-Befelatanana (CHU-JRB) Antananarivo, Madagascar

Hemophagocytic syndrome is due to the activation and nonmalignant proliferation of macrophages and T lymphocytes. The purpose of this report is to describe a 25-year-old man who presented with fever, coughing, and weight loss over the past month. Laboratory findings demonstrated pancytopenia, hyperferritinemia, and cytolysis. The myelogram showed a hemophagocytic syndrome, and tuberculosis bacilli were found in the sputum. Chest radiography and thoracic computed tomography depicted a cavitary lesion suggestive of pulmonary tuberculosis. Treatment of tuberculosis alone, without an immunosuppressant agent, was effective and led to improvement. In a country where tuberculosis is highly endemic, hemophagocytic syndrome should be considered in the differential diagnosis of patients with active tuberculosis complicated by pancytopenia.