研究等業績 - その他 - 髙橋　直人

Two cases of thrombocytopenia, anasarca, fever, reticulin fibrosis/renal failure, and organomegaly (TAFRO) syndrome with high serum procalcitonin levels, including the first case complicated with adrenal hemorrhaging

Nara M.

Internal Medicine ( Internal Medicine )  56 ( 10 ) 1247 - 1252   2017年

Thrombocytopenia, Anasarca, Fever, Reticulin fibrosis/Renal failure, and Organomegaly (TAFRO) syndrome is a recently described systemic inflammatory disorder characterized by thrombocytopenia, anasarca, fever, reticulin fibrosis/renal failure, and organomegaly. It has an acute or subacute onset of unknown etiology, although some pathological features resemble those of multicentric Castleman disease. We here report two cases of TAFRO syndrome. The symptoms and pathological findings in these cases met the 2015 diagnostic criteria. Our cases showed high serum procalcitonin levels, suggesting bacterial infection as an onset trigger. In addition, Case 1 is the first case complicated with adrenal hemorrhaging. Case 2 is the second case of tocilizumab-resistant TAFRO syndrome successfully treated with rituximab.

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両側副腎出血を合併したTAFRO症候群

伊藤 史子, 亀岡 吉弘, 奈良 美保, 鵜生川 久美, 藤島 眞澄, 吉岡 智子, 藤島 直仁, 高橋 直人

日本内科学会雑誌 ( 一般社団法人 日本内科学会 )  106 ( 2 ) 288 - 294   2017年

<p>48歳，男性．発熱，全身性浮腫とリンパ節腫脹で発症し，炎症反応高値，副腎出血，血小板減少，骨髄線維化を認めた．副腎出血による副腎不全を合併した悪性リンパ腫を疑ったが，リンパ節生検にてCastleman病の病理所見と一致し，多彩な臨床症状と検査所見を総合的に判断し，TAFRO症候群と診断した．Prednisolone（PSL）により症状の改善がみられた．頻度は稀だが，本症例のような多彩な臨床症状と特徴的な検査所見を示す場合，TAFRO症候群を念頭に置く必要がある．</p>

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