紅斑性狼瘡以巨噬細胞活化症候群作為初始表現──個案報告

Systemic Lupus Erythematosus with Macrophage Activation Syndrome as Initial Manifestations: A Case Report

噬血症候群是一種被低估的過度發炎狀態，具有高死亡率極容易造成多器官損害。我們報告一名25歲男性患者，他患有間歇性高燒、頭痛和皮疹。他被診斷為紅斑性狼瘡造成的次發性巨噬細胞活化症候群。使用hydrocortisone作為初始治療，隨後使用prednisolone、hydroxychloroquine以及cyclosporine。個案皮疹改善，發燒消退，實驗室檢查顯示血液計數正常，ferritin水平下降。患者隨後在門診進行追蹤，並未出現重大器官損害。

Macrophage activation syndrome (MAS) is an underrecognized hyperinflammatory condition with a high mortality and multi-organ damage. We present a case of a 25-year-old man who suffered from intermittent high-grade fever, headache and distinctive skin rashes. He was diagnosed with MAS, secondary to systemic lupus erythematosus. Treatment with hydrocortisone was initiated, followed by prednisolone, hydroxychloroquine, and cyclosporine. Follow-up data showed improvement in skin lesions, subsidence of fever, and a decrease in ferritin levels, with normalization of complete blood counts. The patient was subsequently followed in the outpatient clinic without significant organ damage.