[Hemophagocytic syndrome secondary to cavitary pulmonary tuberculosis]. / Syndrome d'activation macrophagique secondaire à une tuberculose pulmonaire cavitaire.

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.

Hepatite fulminante associee a un traitement antituberculeux: entite clinique grave mais pas toujours fatale

L'hepatite fulminante est definie par l'association de signes d'encephalopathie hepatique a une chute du taux de prothrombine inferieur a 50survenant moins de deux semaines apres l'apparition d'un ictere. Elle est grave et mortelle en absence de transplantation hepatique. Cependant; nous rapportons un cas d'hepatite fulminante d'evolution favorable sous traitement medical seul. Il s'agissait d'un cas secondaire a un traitement antituberculeux qui a ete arrete tout de suite et remplace par un lavement au lactulose des l'apparition des signes d'encephalopathie hepatique. L'evolution etait marque par un retour progressif de l'etat de conscience a la normale et une amelioration nette du bilan hepatique