Criteria for judging hemophagocytic syndrome

I believe that many people have not heard of what hemophagocytic syndrome is. This disease is actually caused by changes in the phagocytes in the human body. In fact, the phagocytes in human blood have two functions on the human body. On the one hand, the phagocytes can engulf invading bacteria and some waste cells in the body, thus protecting the human body. On the other hand, if the phagocytes become abnormal, they are likely to attack the human body, engulfing the normal cells in the body bit by bit, causing a series of damages to the human body.

In fact, a disease like hemophagocytic syndrome is not big, but it is not small either. But if the situation is serious, it can be fatal. So we still need to handle this disease with caution. The following is an introduction to the criteria for judging this syndrome, hoping it will be helpful to everyone.

1. Fever: Fever for more than 1 week, peak temperature > 38.5"C

2. Hepatosplenomegaly: Hepatosplenomegaly with pancytopenia, cumulatively >= 2 cell lines

3. Cytopenia (decreased peripheral blood cells of the secondary or tertiary lines), with hemoglobin <90 g/L, platelets <100 x 109/L, and neutrophils <1.0 x 109/L

4. Hypertriglyceridemia and/or hypofibrinogenemia

5. Hemophagocytic cells may be seen in the bone marrow, spleen or lymph nodes but without malignant manifestations.

Infectious hemophagocytic syndrome is a benign hemophagocytic histiocytosis associated with acute viral infection. It often occurs in children and is characterized by active proliferation of monocytes and macrophages and obvious phagocytosis of red blood cells. Most patients have obvious high fever, enlarged liver, spleen and lymph nodes, and most of them can recover on their own after the primary disease is treated. The patient has anemia, a significant decrease in white blood cells, and classification shows a significant increase in lymphocytes, which is prone to abnormal lymphocytes. Platelets are often decreased.

The bone marrow is actively proliferating, the proportion of the granulocyte system is reduced, and neutrophils may become toxic. The proliferation of the erythroid system is mostly normal, and the proportion of the lymphatic system has not changed significantly, but abnormal lymphoma may be seen. The mononuclear macrophage system proliferates actively, often >10%. The macrophages are 20~40 microns in size, or larger, with rich cytoplasm, and can phagocytose multiple mature red blood cells, or immature red blood cells or platelets. Megakaryocytes are generally normal.

These judgment criteria are all the situations that may occur with this disease. Of course, we should not be overly cautious and think that there is no cure if we have this disease. Every disease has different levels of severity and urgency, so if it is detected in the early stages, it can be cured quickly. We should face the disease positively and not give up treatment.