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, RESUME Introduction : Le syndrome d'activation macrophagique (SAM), maladie rare, grave et souvent fatale, est la conséquence d'une hyperinflammation secondaire à une dysrégulation du système immunitaire. Les SAM secondaires au sepsis en réanimation sont peu étudiés dans la littérature et leur traitement n'est pas codifié. L'objectif de l'étude était de comparer les caractéristiques cliniques, JAMA. 23 févr, vol.315, issue.8, pp.801-811, 2016.

, en réanimation médicale au CHU de Rouen entre 2000 et 2015 comparant tous les patients atteints d'un choc septique compliqué de SAM selon le HScore (groupe « SAM ») à une cohorte témoin (groupe « Non SAM ») appariée sur l'âge et le score SOFA, Matériels et méthodes : Nous avons réalisé une étude observationnelle, rétrospective

, Il existait plus de recours à l'épuration extra rénale dans la population « SAM » (67% versus 30%, p <0,02), la durée de ventilation mécanique était plus longue (17,5 jours versus 7,5, p<0,05) ainsi que la durée d'épuration extra rénale (5,1 jours versus 1,6, p <0,05) et celle des amines (9,9 jours versus 4,5 jours, p=0,008). La durée moyenne d'hospitalisation en réanimation était significativement plus longue dans le groupe « SAM, Résultats : Au total 37 patients ont été inclus dans la population « SAM ». La mortalité en réanimation était de 59% dans le groupe « SAM » versus 51% dans le groupe non « SAM » (p=0,48), vol.17, p.0

, Conclusion : le SAM secondaire au sepsis en réanimation, peu connu et peu étudié, semble avoir un profil différent et une évolution plus grave sans qu'une différence sur la mortalité ait été retrouvée. Des études complémentaires sont nécessaires afin d'établir la meilleure stratégie thérapeutique chez cette population de patient

, Mots clés : syndrome d'activation macrophagique, choc septique, soins intensifs et de réanimation