Volume 8, Issue 1, June 2020, Page: 11-13
About a Case, Macrophagic Activation Syndrome Post Vaccination
Zakaria Abjaw, Emergency and First Aid Anesthesia Department, Arrazi Hospital, Mohamed VI University Hospital, Marrakech, Morocco
Reda El Hadrami, Emergency and First Aid Anesthesia Department, Arrazi Hospital, Mohamed VI University Hospital, Marrakech, Morocco
Houssam Eddine Sahraoui, Emergency and First Aid Anesthesia Department, Arrazi Hospital, Mohamed VI University Hospital, Marrakech, Morocco
Hamza El Hamzaoui, Emergency and First Aid Anesthesia Department, Arrazi Hospital, Mohamed VI University Hospital, Marrakech, Morocco
Taoufik Abouelhassan, Emergency and First Aid Anesthesia Department, Arrazi Hospital, Mohamed VI University Hospital, Marrakech, Morocco
Ghita Beddou, Department of Biological Hematology, Avicenne Military Hospital, Marrakech, Morocco
Hicham Yahyaoui, Department of Biological Hematology, Avicenne Military Hospital, Marrakech, Morocco
Imane Benjelloun, Department of Biological Hematology, Avicenne Military Hospital, Marrakech, Morocco
Mustapha Ait Ameur, Department of Biological Hematology, Avicenne Military Hospital, Marrakech, Morocco
Mohamed Chakour, Department of Biological Hematology, Avicenne Military Hospital, Marrakech, Morocco
Received: Jan. 26, 2020;       Accepted: Feb. 14, 2020;       Published: Mar. 17, 2020
DOI: 10.11648/j.ijacm.20200801.13      View  265      Downloads  41
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.
Keywords
Macrophage Activation Syndrome, Hemophagocytosis, Vaccination Antimalarial
To cite this article
Zakaria Abjaw, Reda El Hadrami, Houssam Eddine Sahraoui, Hamza El Hamzaoui, Taoufik Abouelhassan, Ghita Beddou, Hicham Yahyaoui, Imane Benjelloun, Mustapha Ait Ameur, Mohamed Chakour, About a Case, Macrophagic Activation Syndrome Post Vaccination, International Journal of Anesthesia and Clinical Medicine. Vol. 8, No. 1, 2020, pp. 11-13. doi: 10.11648/j.ijacm.20200801.13
Copyright
Copyright © 2020 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Reference
[1]
A. Pradalier et al. Syndrome d’activation macrophagique (syndrome d’hémaphagocytose). Pathologie biologie 52 (2014) 407-414.
[2]
M Penel-Page et al. Pièges diagnostiques d’un syndrome d’activation macrophagique. Archives de Pédiatrie 2017; 24: 254-259.
[3]
C. Créput et al. Syndrome d’activation lymphohistiocytaire: revue de la littérature, implications en réanimation. Réanimation 14 (2005) 604–613.
[4]
O. Lambotte. Syndrome d’activation macrophagique. Rev Med Interne 2014; 355: A24—30.
[5]
R. Rekik et al. syndrome d’activation macrophagique réactionnel: une cause sous estimée de défaillance multiviscérale en reanimation? Annales Françaises d’Anesthésie et de Réanimation 23 (2004) 1189–1191.
[6]
A. Karras, O. hermine. Syndrome d’activation macrophagique. La revue de medicine interne 23 (2002) 768-778.
[7]
F. Gonzalez et al. Syndrome d’activation macrophagique d’origine infectieuse: étiologies et prise en charge. Réanimation June 2009; 18 (4): 284-290.
[8]
C. Larroche. Syndrome d’activation macrophagique de l’adulte: état des connaissances en 2003. Mini-revue Sang Thrombose Vaisseaux 2003; 15, n° 3: 135–42.
[9]
R. Clement et al. Macrophage activation syndrome: An autopsy case of sudden death. Journal of Clinical Forensic Medicine 2006; 13: 356–360.
[10]
C. Créput et al. Syndrome d’activation lymphohistiocytaire: revue de la littérature, implications en réanimation. Pathophysiology of organ dysfunction in the macrophage activation syndrome. Réanimation 2005; 14: 604–613.
[11]
Bilbault et al. Syndrome d’activation macrophagique: un diagnostic à évoquer dévant une pancytopénie fébrile inexpliquée en réanimation. Rean. Urg 1995; 4 (5): 607-610.
[12]
A. D. Billiau et al. Macrophage activation syndrome: characteristic findings on liver biopsy illustrating the key role of activated, IFN-gamma-producing lymphocytes and IL-6- and TNF-alphaproducing macrophages, Blood 2005; 105: 1648–1651.
[13]
L. Rossi-Semerano et al. Macrophage activation syndrome revealing familial Mediterranean fever. Arthr Care Res 2011; 63: 780–3.
[14]
A. Ravelli et al. Preliminary diagnostic guidelines for macrophage activation syndrome complicating systemic juvenile idiopathic arthritis. J Pediatr 2005; 146: 598–604.
[15]
A. Coca et al. Macrophage activation syndrome: serological markers and treatment with anti thymocyte globulin. Clin Immunol 2009; 132: 10–18.
Browse journals by subject