A case of severe fever with thrombocytopenia syndrome with significantly prolonged activated partial thromboplastin time
10.3760/cma.j.cn112866-20250212-00022
- VernacularTitle:重症发热伴血小板减少综合征并活化部分凝血活酶时间显著延长1例
- Author:
Yishan HE
1
;
Sai WEN
1
;
Nannan XU
1
;
Gang WANG
1
Author Information
1. 山东大学齐鲁医院感染性疾病科，济南 250012
- Publication Type:Journal Article
- Keywords:
Severe fever with thrombocytopenia syndrome;
Activated partial thromboplastin time;
Hemophagocytic lymphohistiocytosis;
Cytokine storm;
Endothelial functi
- From:
Chinese Journal of Experimental and Clinical Virology
2025;39(2):231-235
- CountryChina
- Language:Chinese
-
Abstract:
Patients with severe fever with thrombocytopenia syndrome (SFTS) often experience coagulation dysfunction. This article reports a case of a critical SFTS patient who developed secondary hemophagocytic lymphohistiocytosis (HLH) and accompanied by significantly prolonged activated partial thromboplastin time (APTT)(111.0 s). APTT mixing test, coagulation factor activity assays, and antiphospholipid antibodies testing excluded coagulation factor deficiencies and classic antiphospholipid syndrome. Combined with elevated endothelial injury markers, it was hypothesized that the prolonged APTT was related to endothelial injury. The patient was treated with dexamethasone, ruxolitinib, and plasma transfusion, the patient′s APTT returned to normal (34.6 s), platelets increased, and levels of ferritin, inflammatory cytokines, and vascular endothelial injury markers decreased. This case suggests that prolonged APTT in SFTS patients may be associated with HLH, cytokine storms, and endothelial injury. Glucocorticoid and Janus kinase inhibitor, by controlling inflammatory responses and reducing endothelial damage, may have potential therapeutic value in correcting coagulation abnormalities.
