{"id":25206,"date":"2023-04-20T11:02:18","date_gmt":"2023-04-20T04:02:18","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=25206"},"modified":"2023-04-20T16:09:53","modified_gmt":"2023-04-20T09:09:53","slug":"tong-quan-hoi-chung-thuc-bao-mau","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/20\/tong-quan-hoi-chung-thuc-bao-mau\/","title":{"rendered":"T\u1ed5ng quan h\u1ed9i ch\u1ee9ng th\u1ef1c b\u00e0o m\u00e1u"},"content":{"rendered":"

Hi\u1ec7n t\u01b0\u1ee3ng th\u1ef1c b\u00e0o (hemophagocytosis<\/a>) l\u00e0 hi\u1ec7n t\u01b0\u1ee3ng \u0111\u1ea1i th\u1ef1c b\u00e0o \u201c\u0103n\u201d h\u1ed3ng c\u1ea7u, ti\u1ec3u c\u1ea7u, b\u1ea1ch c\u1ea7u v\u00e0 c\u00e1c t\u1ebf b\u00e0o \u0111\u1ea7u d\u00f2ng trong t\u1ee7y x\u01b0\u01a1ng v\u00e0 m\u00f4. H\u1ed9i ch\u1ee9ng th\u1ef1c b\u00e0o m\u00e1u (hemophagocytic lymphohistiocytosis \u2013 HLH) l\u00e0 h\u1ed9i ch\u1ee9ng do t\u0103ng ph\u1ea3n \u1ee9ng vi\u00eam qu\u00e1 m\u1ee9c g\u00e2y \u0111e d\u1ecda t\u00ednh m\u1ea1ng do t\u0103ng ti\u1ebft cytokin h\u00e0ng lo\u1ea1t g\u00e2y r\u1ed1i lo\u1ea1n \u0111i\u1ec1u h\u00f2a mi\u1ec5n d\u1ecbch.<\/strong><\/p>\n

1. Ph\u00e2n lo\u1ea1i h\u1ed9i ch\u1ee9ng th\u1ef1c b\u00e0o m\u00e1u\u00a0 \u00a0 \u00a0 \u00a0<\/strong><\/h2>\n

HLH nguy\u00ean ph\u00e1t:<\/strong><\/p>\n

Familial HLH: c\u00f3 5 type<\/p>\n

    \n
  • FHL1: Khi\u1ebfm khuy\u1ebft NST s\u1ed1 9 (9q21.3 -22)<\/li>\n
  • FHL2: PRF1<\/li>\n
  • FHL3: UNC13D<\/li>\n
  • FHL4: STX11<\/li>\n
  • FHL5: STXBP2<\/li>\n<\/ul>\n

    V\u1eabn c\u00f2n nhi\u1ec1u gene ch\u01b0a bi\u1ebft<\/p>\n

    Li\u00ean quan suy gi\u1ea3m mi\u1ec5n d\u1ecbch b\u1ea9m sinh<\/p>\n

      \n
    • H\u1ed9i ch\u1ee9ng Chediak-Higashi (RAB27A)<\/li>\n
    • H\u1ed9i ch\u1ee9ng Griscelli type 2 (LYST)<\/li>\n
    • H\u1ed9i ch\u1ee9ng t\u0103ng sinh lympho li\u00ean quan nhi\u1ec5m s\u1eafc th\u1ec3 gi\u1edbi t\u00ednh X (SAP)<\/li>\n<\/ul>\n

      HLH th\u1ee9 ph\u00e1t:<\/strong><\/p>\n

        \n
      • Do nhi\u1ec5m tr\u00f9ng: th\u01b0\u1eddng g\u1eb7p nh\u1ea5t l\u00e0 sau nhi\u1ec5m virus (EBV, CMV, Parvovirus, Herpes simplex, Varicella zoster, s\u1edfi, HHV 8, HIV\u2026), nhi\u1ec5m vi khu\u1ea9n (gram \u00e2m, Brucella, lao\u2026) , k\u00fd sinh tr\u00f9ng (Leishmania) v\u00e0 nhi\u1ec5m n\u1ea5m.<\/li>\n
      • B\u1ec7nh t\u1ef1 mi\u1ec5n: lupus, vi\u00eam kh\u1edbp d\u1ea1ng th\u1ea5p, b\u1ec7nh Still, vi\u00eam n\u00fat quanh \u0111\u1ed9ng m\u1ea1ch, u h\u1ea1t th\u1ec3 ph\u1ed5i, x\u01a1 c\u1ee9ng b\u00ec h\u1ec7 th\u1ed1ng, h\u1ed9i ch\u1ee9ng Sjogren\u2026.<\/li>\n
      • B\u1ec7nh l\u00fd \u00e1c t\u00ednh: leukemia, lymphoma\u2026<\/li>\n
      • HLH th\u1ee9 ph\u00e1t sau h\u00f3a tr\u1ecb, sau gh\u00e9p gan hay th\u1eadn ho\u1eb7c d\u00f9ng thu\u1ed1c \u1ee9c ch\u1ebf mi\u1ec5n d\u1ecbch\u2026<\/li>\n<\/ul>\n

        2. Sinh l\u00fd b\u1ec7nh<\/strong><\/h2>\n

        Lympho T t\u0103ng sinh v\u00e0 ho\u1ea1t h\u00f3a qu\u00e1 m\u1ee9c g\u00e2y ho\u1ea1t h\u00f3a \u0111\u1ea1i th\u1ef1c b\u00e0o.<\/p>\n

        \u1ea2nh h\u01b0\u1edfng qua l\u1ea1i gi\u1eefa t\u1ebf b\u00e0o NK ho\u1ea1t h\u00f3a, lympho T v\u00e0 t\u0103ng sinh cytokine (\u1d67IFN, TNF\u03b1, GM \u2013 CSF, IL1, IL6)<\/p>\n

        \u1ea2nh h\u01b0\u1edfng c\u1ee7a c\u01a1 quan \u0111\u00edch khi cytokine ho\u1ea1t h\u00f3a qu\u00e1 m\u1ee9c.<\/p>\n

        C\u01a1 ch\u1ebf HLH li\u00ean quan EBV: t\u00e1c nh\u00e2n h\u00e0ng \u0111\u1ea7u trong HLH th\u1ee9 ph\u00e1t sau nhi\u1ec5m tr\u00f9ng.<\/p>\n

        C\u01a1 ch\u1ebf FHL (5 th\u1ec3)<\/p>\n

        3. Ch\u1ea9n \u0111o\u00e1n<\/strong><\/h2>\n

        3.1 L\u00e2m s\u00e0ng<\/strong><\/h3>\n

        Tri\u1ec7u ch\u1ee9ng kh\u00f4ng \u0111\u1eb7c hi\u1ec7u, c\u00f3 th\u1ec3 kh\u1edfi ph\u00e1t nh\u01b0 nhi\u1ec5m tr\u00f9ng th\u00f4ng th\u01b0\u1eddng hay s\u1ed1t k\u00e9o d\u00e0i kh\u00f4ng r\u00f5 nguy\u00ean nh\u00e2n, ho\u1eb7c c\u1ee7a b\u1ec7nh l\u00fd \u00e1c t\u00ednh, ho\u1eb7c c\u1ee7a b\u1ec7nh t\u1ef1 mi\u1ec5n.<\/p>\n

        D\u1ea5u hi\u1ec7u th\u01b0\u1eddng g\u1eb7p: s\u1ed1t k\u00e9o d\u00e0i, gan l\u00e1ch to, tri\u1ec7u ch\u1ee9ng th\u1ea7n kinh trung \u01b0\u01a1ng: co gi\u1eadt, li\u1ec7t d\u00e2y th\u1ea7n kinh s\u1ecd, r\u1ed1i lo\u1ea1n tri gi\u00e1c\u2026<\/p>\n

        D\u1ea5u hi\u1ec7u \u00edt g\u1eb7p h\u01a1n: h\u1ea1ch to, ph\u00e1t ban, v\u00e0ng da\u2026<\/p>\n

        Kh\u00e1m l\u00e2m s\u00e0ng:\u00a0 \u0111\u00e1nh gi\u00e1 sinh hi\u1ec7u, t\u1ed5ng tr\u1ea1ng, t\u00ecm d\u1ea5u hi\u1ec7u v\u00e0ng da, rash, xu\u1ea5t huy\u1ebft, thi\u1ebfu m\u00e1u, gan , l\u00e1ch , h\u1ea1ch, tri\u1ec7u ch\u1ee9ng th\u1ea7n kinh, \u00a0c\u00e1c tri\u1ec7u ch\u1ee9ng li\u00ean quan nguy\u00ean nh\u00e2n.<\/p>\n

        3.2 C\u1eadn l\u00e2m s\u00e0ng<\/strong><\/h3>\n

        C\u00e1c nh\u00f3m x\u00e9t nghi\u1ec7m<\/p>\n

          \n
        • X\u00e9t nghi\u1ec7m t\u00ecm nguy\u00ean nh\u00e2n s\u1ed1t k\u00e9o d\u00e0i<\/li>\n
        • X\u00e9t nghi\u1ec7m ch\u1ea9n \u0111o\u00e1n h\u1ed9i ch\u1ee9ng th\u1ef1c b\u00e0o m\u00e1u<\/li>\n
        • X\u00e9t nghi\u1ec7m t\u00ecm nguy\u00ean nh\u00e2n th\u1ef1c b\u00e0o m\u00e1u<\/li>\n
        • X\u00e9t nghi\u1ec7m t\u00ecm bi\u1ebfn ch\u1ee9ng v\u00e0 theo d\u00f5i<\/li>\n<\/ul>\n

          C\u00f4ng th\u1ee9c m\u00e1u, huy\u1ebft \u0111\u1ed3 : gi\u1ea3m c\u00e1c d\u00f2ng t\u1ebf b\u00e0o m\u00e1u, trong \u0111\u00f3 thi\u1ebfu m\u00e1u v\u00e0 gi\u1ea3m ti\u1ec3u c\u1ea7u l\u00e0 d\u1ea5u hi\u1ec7u th\u01b0\u1eddng g\u1eb7p nh\u1ea5t, do b\u1ecb \u1ee9c ch\u1ebf b\u1edfi \u1d67IFN, TNF\u03b1 v\u00e0 t\u0103ng ti\u00eau th\u1ee5 do hi\u1ec7n t\u01b0\u1ee3ng th\u1ef1c b\u00e0o m\u00e1u<\/p>\n

          Ch\u1ee9c n\u0103ng gan th\u1eadn, \u0111i\u1ec7n gi\u1ea3i \u0111\u1ed3, CRP, \u0111i\u1ec7n gi\u1ea3i \u0111\u1ed3<\/p>\n

          C\u1ea5y m\u00e1u, k\u00fd sinh tr\u00f9ng s\u1ed1t r\u00e9t, n\u1ea5m, widal, x\u00e9t nghi\u1ec7m HIV, c\u1ea5y n\u01b0\u1edbc ti\u1ec3u, d\u1ecbch n\u00e3o t\u1ee7y…<\/p>\n

          Ch\u1ea9n \u0111o\u00e1n h\u00ecnh \u1ea3nh: Xquang ng\u1ef1c, si\u00eau \u00e2m b\u1ee5ng, CTscans, MRI<\/p>\n

          T\u0103ng ferritine m\u00e1u do nhi\u1ec1u c\u01a1 ch\u1ebf: ph\u00f3ng th\u00edch t\u1eeb m\u00f4 t\u1ed5n th\u01b0\u01a1ng, t\u0103ng ti\u1ebft t\u1eeb \u0111\u1ea1i th\u1ef1c b\u00e0o v\u00e0 t\u0103ng ph\u00f3ng th\u00edch khi h\u1ed3ng c\u1ea7u b\u1ecb th\u1ef1c b\u00e0o v\u00e0 do TNF\u03b1 l\u00e0m t\u0103ng bi\u1ec3u hi\u1ec7n c\u1ee7a gen \u0111i\u1ec1u h\u00f2a ferritine, gi\u1ea3m \u0111\u1ed9 thanh th\u1ea3i do gi\u1ea3m glycosyl h\u00f3a. \u0110\u1ec3 ch\u1ea9n \u0111o\u00e1n HLH, ng\u01b0\u1ee1ng ferritin >500\u03bcg\/L c\u00f3 \u0111\u1ed9 nh\u1ea1y 82% v\u00e0 \u0111\u1ed9 \u0111\u1eb7c hi\u1ec7u 42%\u00a0 so v\u1edbi ng\u01b0\u1ee1ng\u00a0 ferritin >10,000 \u03bcg\/L c\u00f3 \u0111\u1ed9 nh\u1ea1y 90% v\u00e0 \u0111\u1ed9 \u0111\u1eb7c hi\u1ec7u 96%.<\/p>\n

          T\u0103ng triglyceride m\u00e1u do t\u0103ng TNF\u03b1 g\u00e2y \u1ee9c ch\u1ebf ho\u1ea1t \u0111\u1ed9ng c\u1ee7a lipoprotein lipase<\/p>\n

          Gi\u1ea3m fibrinogen m\u00e1u do \u0111\u1ea1i th\u1ef1c b\u00e0o t\u0103ng ho\u1ea1t h\u00f3a g\u00e2y t\u0103ng plasminogen ho\u1ea1t h\u00f3a.<\/p>\n

          Gi\u1ea3m ho\u1ea1t h\u00f3a t\u1ebf b\u00e0o NK, t\u0103ng th\u1ee5 th\u1ec3 IL2 h\u00f2a tan (sCD25), t\u0103ng LDH,\u00a0 t\u0103ng men gan v\u00e0 billirubin.<\/p>\n

          Gi\u1ea3i ph\u1eabu b\u1ec7nh c\u00f3 h\u00ecnh \u1ea3nh th\u1ef1c b\u00e0o tr\u00ean t\u1ee7y \u0111\u1ed3 ho\u1eb7c sinh thi\u1ebft h\u1ea1ch.<\/p>\n

          \"minh-hoa-hoi-chung-thuc-bao-mau\"<\/p>\n

          \u0110\u1ecbnh l\u01b0\u1ee3ng kh\u00e1ng th\u1ec3 IgG, IgA, IgM, IgE.<\/p>\n

          T\u1ea7m so\u00e1t nguy\u00ean nh\u00e2n t\u1ef1 mi\u1ec5n: ANA, C3,C4, Anti DsDNA.<\/p>\n

          T\u1ea7m so\u00e1t virus: HIV, CMV, EBV, HSV , parvovirus..<\/p>\n

          Sinh h\u1ecdc ph\u00e2n t\u1eed: t\u1ea7m so\u00e1t bi\u1ec3u hi\u1ec7n perforin, t\u00ecm c\u00e1c \u0111\u1ed9t bi\u1ebfn gen\u2026.<\/p>\n

          3.3 Ti\u00eau chu\u1ea9n ch\u1ea9n \u0111o\u00e1n theo Hi\u1ec7p h\u1ed9i m\u00f4 b\u00e0o th\u1ebf gi\u1edbi<\/strong><\/p>\n

          Ti\u00eau chu\u1ea9n ch\u1ea9n \u0111o\u00e1n theo HLH 94 ch\u1ec9 c\u00f3 5 ti\u00eau chu\u1ea9n, \u0111\u1ebfn HLH 2004 c\u00f3 th\u00eam 3 ti\u00eau chu\u1ea9n:<\/p>\n

            \n
          • S\u1ed1t k\u00e9o d\u00e0i ( nhi\u1ec7t \u0111\u1ed9 > 38.5o<\/sup>C, k\u00e9o d\u00e0i nhi\u1ec1u h\u01a1n ho\u1eb7c b\u1eb1ng 7 ng\u00e0y)<\/li>\n
          • L\u00e1ch to (> 3 cm d\u01b0\u1edbi h\u1ea1 s\u01b0\u1eddn ph\u1ea3i)<\/li>\n
          • Gi\u1ea3m 2 tr\u00ean 3 d\u00f2ng t\u1ebf b\u00e0o (Hemoglobin <9.0 g\/dL ho\u1eb7c ti\u1ec3u c\u1ea7u <100,000\/\u03bcL ho\u1eb7c neutrophil <1000\/\u03bcL)<\/li>\n
          • T\u0103ng triglyceride m\u00e1u (> 3.0 mmol\/L ho\u1eb7c 265 mg\/dl) ho\u1eb7c gi\u1ea3m fibrinogen m\u00e1u (<1.5 g\/L)<\/li>\n
          • C\u00f3 h\u00ecnh \u1ea3nh th\u1ef1c b\u00e0o m\u00e1u \u1edf t\u1ee7y x\u01b0\u01a1ng ho\u1eb7c l\u00e1ch ho\u1eb7c h\u1ea1ch m\u00e0 kh\u00f4ng k\u00e8m theo b\u1eb1ng ch\u1ee9ng \u00e1c t\u00ednh.<\/li>\n
          • Gi\u1ea3m hay m\u1ea5t ho\u1ea1t l\u1ef1c t\u1ebf b\u00e0o NK<\/li>\n
          • T\u0103ng ferritine m\u00e1u ( >500\u03bcg\/L)<\/li>\n
          • T\u0103ng CD25 h\u00f2a tan ( > 2400 U\/mL)<\/li>\n<\/ul>\n

            Ch\u1ea9n \u0111o\u00e1n HLH khi b\u1ec7nh nh\u00e2n c\u00f3 \u0111\u1ee7 5\/8 ti\u00eau chu\u1ea9n ho\u1eb7c khi c\u00f3\u00a0 mang \u0111\u1ed9t bi\u1ebfn gen ph\u00f9 h\u1ee3p HLH nguy\u00ean ph\u00e1t.<\/p>\n

            4. H\u01b0\u1edbng \u0111i\u1ec1u tr\u1ecb h\u1ed9i ch\u1ee9ng th\u1ef1c b\u00e0o m\u00e1u<\/strong><\/h2>\n

            4.1 H\u01b0\u1edbng \u0111i\u1ec1u tr\u1ecb<\/strong><\/h3>\n

            Cho \u0111\u1ebfn tr\u01b0\u1edbc 1994, 90% ca HLH th\u1ea5t b\u1ea1i v\u1edbi \u0111i\u1ec1u tr\u1ecb.<\/p>\n

            HLH 94: ph\u00e1c \u0111\u1ed3 \u0111i\u1ec1u tr\u1ecb HLH qu\u1ed1c t\u1ebf \u0111\u1ea7u ti\u00ean bao g\u1ed3m h\u00f3a tr\u1ecb k\u1ebft h\u1ee3p li\u1ec7u ph\u00e1p mi\u1ec5n d\u1ecbch, steroids, kh\u00e1ng sinh, kh\u00e1ng virus v\u00e0 sau \u0111\u00f3 c\u00f3 th\u1ec3 gh\u00e9p t\u1ee7y. Ph\u00e1c \u0111\u1ed3 g\u1ed3m 2 giai \u0111o\u1ea1n: t\u1ea5n c\u00f4ng (8 tu\u1ea7n) v\u00e0 giai \u0111o\u1ea1n duy tr\u00ec c\u00f3 th\u1ec3 l\u00ean \u0111\u1ebfn 40 tu\u1ea7n, t\u1ef7 l\u1ec7 s\u1ed1ng \u0111\u1ea1t 55% v\u1edbi th\u1eddi gian theo d\u00f5i trung b\u00ecnh 3.1 n\u0103m.<\/p>\n

            HLH 2004 c\u00f3 b\u1ed5 sung cyclosporin A ngay t\u1eeb giai \u0111oan t\u1ea5n c\u00f4ng thay v\u00ec t\u1eeb tu\u1ea7n th\u1ee9 9 tr\u1edf \u0111i.<\/p>\n

            \u0110i\u1ec1u tr\u1ecb c\u1ea7n \u0111\u1ea1t 2 m\u1ee5c ti\u00eau: m\u1ee5c ti\u00eau ngay l\u1eadp t\u1ee9c v\u00e0 m\u1ee5c ti\u00eau l\u00e2u d\u00e0i.<\/p>\n

            Nguy\u00ean t\u1eafc \u0111i\u1ec1u tr\u1ecb:<\/p>\n

              \n
            • \u1ee8c ch\u1ebf ph\u1ea3n \u1ee9ng vi\u00eam: steroid (dexamethasone), cyclosporin A, methotrexate ti\u00eam k\u00eanh t\u1ee7y , hydrocortisone (\u1edf b\u1ec7nh nh\u00e2n c\u00f3 tri\u1ec7u ch\u1ee9ng th\u1ea7n kinh trung \u01b0\u01a1ng k\u00e9o d\u00e0i), IVIG<\/li>\n
            • C\u1eaft qu\u00e1 tr\u00ecnh k\u00edch th\u00edch tr\u00ecnh di\u1ec7n kh\u00e1ng nguy\u00ean t\u1ebf b\u00e0o qu\u00e1 m\u1ee9c : Etoposide (VP 16)<\/li>\n
            • \u0110i\u1ec1u tr\u1ecb nguy\u00ean nh\u00e2n kh\u1edfi ph\u00e1t ( nhi\u1ec5m tr\u00f9ng, b\u1ec7nh \u00e1c t\u00ednh\u2026)<\/li>\n
            • \u0110i\u1ec1u tr\u1ecb h\u1ed7 tr\u1ee3 (kh\u00e1ng sinh ph\u00f2ng ng\u1eeba, kh\u00e1ng n\u1ea5m, h\u1ed7 tr\u1ee3 d\u1ea1 d\u00e0y\u2026)<\/li>\n
            • Gh\u00e9p t\u1ee7y: khi ch\u1ea9n \u0111o\u00e1n HLH nguy\u00ean ph\u00e1t ho\u1eb7c HLH \u0111\u00e1p \u1ee9ng k\u00e9m sau 8 tu\u1ea7n t\u1ea5n c\u00f4ng, ho\u1eb7c khi b\u1ec7nh nh\u00e2n c\u00f3 bi\u1ec3u hi\u1ec7n th\u1ea7n kinh trung \u01b0\u01a1ng.<\/li>\n<\/ul>\n

              4.2. C\u00e1c h\u01b0\u1edbng \u0111i\u1ec1u tr\u1ecb kh\u00e1c:<\/h3>\n
                \n
              • ATG<\/li>\n
              • IVIG<\/li>\n
              • Rituximab (HLH li\u00ean quan EBV)<\/li>\n
              • Th\u1eed nghi\u1ec7m l\u00e2m s\u00e0ng: ph\u1ed1i h\u1ee3p ATG + Etoposide, Methotrexate ti\u00eam k\u00eanh t\u1ee7y v\u00e0 hydrocortisone.<\/li>\n<\/ul>\n

                T\u00c0I LI\u1ec6U THAM KH\u1ea2O<\/p>\n

                  \n
                1. L\u00e2m Th\u1ecb M\u1ef9 (2007). C\u00e1c th\u00e1ch th\u1ee9c trong x\u1eed tr\u00ed H\u1ed9i ch\u1ee9ng th\u1ef1c b\u00e0o m\u00e1u t\u1ea1i B\u1ec7nh vi\u1ec7n Nhi \u0110\u1ed3ng 1 TPHCM. Y h\u1ecdc TP H\u1ed3 Ch\u00ed Minh; 11:29-45.<\/li>\n
                2. Nguy\u1ec5n \u0110\u1ee9c To\u00e0n, Tr\u1ea7n Th\u1ecb M\u1ed9ng Hi\u1ec7p (2010). Y\u1ebfu t\u1ed1 ti\u00ean l\u01b0\u1ee3ng t\u1eed vong \u1edf tr\u1ebb m\u1eafc H\u1ed9i ch\u1ee9ng th\u1ef1c b\u00e0o m\u00e1u. Y H\u1ecdc TP H\u1ed3 Ch\u00ed Minh;<\/li>\n
                3. Tr\u1ea7n Th\u1ecb M\u1ed9ng Hi\u1ec7p (2012). B\u00e0i gi\u1ea3ng Nhi Khoa sau \u0111\u1ea1i h\u1ecdc. Tr\u01b0\u1eddng \u0110\u1ea1i h\u1ecdc Y khoa Ph\u1ea1m Ng\u1ecdc Th\u1ea1ch. Tr\u1ea7n Th\u1ecb M\u1ed9ng Hi\u1ec7p, Tr\u1ea7n Ph\u1ea9m Di\u1ec7u. H\u1ed9i ch\u1ee9ng th\u1ef1c b\u00e0o m\u00e1u (2006). Ph\u00e1c \u0111\u1ed3 \u0111i\u1ec1u tr\u1ecb B\u1ec7nh vi\u1ec7n Nhi \u0110\u1ed3ng 2.<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"

                  Hi\u1ec7n t\u01b0\u1ee3ng th\u1ef1c b\u00e0o (hemophagocytosis) l\u00e0 hi\u1ec7n t\u01b0\u1ee3ng \u0111\u1ea1i th\u1ef1c b\u00e0o \u201c\u0103n\u201d h\u1ed3ng c\u1ea7u, ti\u1ec3u c\u1ea7u, b\u1ea1ch c\u1ea7u v\u00e0 c\u00e1c t\u1ebf b\u00e0o \u0111\u1ea7u d\u00f2ng trong t\u1ee7y x\u01b0\u01a1ng v\u00e0 m\u00f4. H\u1ed9i ch\u1ee9ng th\u1ef1c b\u00e0o m\u00e1u (hemophagocytic lymphohistiocytosis \u2013 HLH) l\u00e0 h\u1ed9i ch\u1ee9ng do t\u0103ng ph\u1ea3n \u1ee9ng vi\u00eam qu\u00e1 m\u1ee9c g\u00e2y \u0111e d\u1ecda t\u00ednh m\u1ea1ng do t\u0103ng […]<\/p>\n","protected":false},"author":16,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[15,33],"tags":[3],"yoast_head":"\nT\u1ed5ng quan h\u1ed9i ch\u1ee9ng th\u1ef1c b\u00e0o m\u00e1u - Vinmec<\/title>\n<meta name=\"description\" content=\"H\u1ed9i ch\u1ee9ng th\u1ef1c b\u00e0o m\u00e1u (hemophagocytic lymphohistiocytosis \u2013 HLH): h\u1ed9i ch\u1ee9ng do t\u0103ng ph\u1ea3n \u1ee9ng vi\u00eam qu\u00e1 m\u1ee9c g\u00e2y \u0111e d\u1ecda t\u00ednh m\u1ea1ng.\" \/>\n<meta name=\"robots\" content=\"noindex, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"T\u1ed5ng quan h\u1ed9i ch\u1ee9ng th\u1ef1c b\u00e0o m\u00e1u - 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