CAJ | 학술논문

目的：提高不明原因发热(fever of unknown origin，FUO)病因诊断中对慢性粒单核细胞白血病(chronic myelomonocytic leukemia，CMML)的认识，探讨CMML临床特点，Sweet综合征(Sweet's syndrome，SS)与CMML的关系。方法回顾1例以不明原因发热就诊，合并SS，最后确诊为CMML青年男性患者的临床资料并复习相关文献。结果患者长期发热，病程中出现痛性皮疹，皮肤活检示中性粒细胞浸润符合SS。肺CT示肺部感染，巨细胞病毒COPY阳性，外周血单核细胞计数持续高于1.0×109/L，骨髓形态可见2系病态造血，先后诊断为SS合并肺炎，巨细胞病毒感染等，抗感染及激素治疗无效，并除外其他引起单核细胞计数高的疾病后诊断为CMML。结论 CMML临床症状可有长期发热，SS可为CMML前驱症状。
목적：제고불명원인발열(fever of unknown origin，FUO)병인진단중대만성립단핵세포백혈병(chronic myelomonocytic leukemia，CMML)적인식，탐토CMML림상특점，Sweet종합정(Sweet's syndrome，SS)여CMML적관계。방법회고1례이불명원인발열취진，합병SS，최후학진위CMML청년남성환자적림상자료병복습상관문헌。결과환자장기발열，병정중출현통성피진，피부활검시중성립세포침윤부합SS。폐CT시폐부감염，거세포병독COPY양성，외주혈단핵세포계수지속고우1.0×109/L，골수형태가견2계병태조혈，선후진단위SS합병폐염，거세포병독감염등，항감염급격소치료무효，병제외기타인기단핵세포계수고적질병후진단위CMML。결론 CMML림상증상가유장기발열，SS가위CMML전구증상。
Objective To improve our understanding of chronic myelomonocytic leukemia (CMML) in etiological diagnosis of fever of unknown origin (FUO) and to study the clinical characteristics of CMML and the relation between Sweet's syndrome (SS) and CMML. Methods Clinical data about 1 patient with FUO accompanying SS were retrospectively analyzed with its relevant literature reviewed.Results The patient suffered from chronic fever with painful skin rashes. Laboratory test showed that the number of peripheral mononuclear cells was>1.0×109/L and bone marrow morphology revealed pathological hematopoietic cells. The patient who was diagnosed with SS accompanying pneumonia and cytomegalovirus infection had no response to anti-infection and hormone therapy. After other causes that increased the number of mononuclear cells were excluded, the patient wasfinally diagnosed with CMML.Conclusion CMML is manifested as chronic fever with SS as its precursory symptom.