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VOLUME 24 , ISSUE 1 ( January, 2020 ) > List of Articles

CASE REPORT

Hemophagocytic Lymphohistiocytosis Related to Tuberculosis Disease

Seher Erdoğan, Deniz Çakır, Tuğçe Bozkurt, Burcu Karakayalı, Sevinç Kalın, Begüm Koç, Betül Sözeri

Keywords : Hemophagocytic lymphohistiocytosis, Therapeutic plasma exchange, Tuberculosis

Citation Information : Erdoğan S, Çakır D, Bozkurt T, Karakayalı B, Kalın S, Koç B, Sözeri B. Hemophagocytic Lymphohistiocytosis Related to Tuberculosis Disease. Indian J Crit Care Med 2020; 24 (1):63-65.

DOI: 10.5005/jp-journals-10071-23329

License: CC BY-NC 4.0

Published Online: 01-01-2020

Copyright Statement:  Copyright © 2020; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Hemophagocytic lymphohistiocytosis (HLH) is a rare, albeit potentially fatal, condition in which fever, hepatosplenomegaly, and cytopenia predominate the clinical picture. Although it may be primary, it may also develop secondary to various etiologies. Herein, we aimed to report a patient who was diagnosed with pulmonary tuberculosis, developed fever and cytopenia during follow-up, and received immunomodulatory therapy together with antituberculosis therapy for the diagnosis of HLH. Sequencing of PRF1 showed heterozygous mutation. Although primary HLH has been detected in infants and children, genetic mutation of genes should be considered a differential diagnosis of HLH even in the adolescent.


  1. Tseng YT, Sheng WH, Lin BH, Lin CW, Wang JT, Chen YC, et al. Causes, clinical symptoms, and outcomes of infectious disease associated with hemophagocytic lymphohistiocytosis in Taiwanese adults. J Microbiol Immunol Infect 2011;44(3):191–197. DOI: 10.1016/j.jmii.2011.01.027.
  2. Bosnak M, Erdoğan S, Aktekin EH, Bay A. Therapeutic plasma exchange in primary hemophagocytic lymphohistiocytosis: reports of two cases and a review of the literature. Transfus Apher Sci 2016;55(3):353–356. DOI: 10.1016/j.transci.2016.09.015.
  3. Zhang Y, Liang G, Qin H, Li Y, Zeng X. Tuberculosis-associated hemophagocytic lymphohistiocytosis with initial presentation of fever of unknown origin in a general hospital: an analysis of clinical cases. Medicine (Baltimore) 2017;96(16):e6575. DOI: 10.1097/MD.0000000000006575.
  4. Karras A, Hermine O. Hemophagocytic syndrome. Rev Med Interne 2002;23(9):768–778. DOI: 10.1016/S0248-8663(02)00673-2.
  5. Ramos-Casals M, Brito-Zeron P, Lopez-Guillermo A, Khamashta MA, Bosch X. Adult haemophagocytic syndrome. Lancet 2013;383(9927):1503–1516. DOI: 10.1016/S0140-6736(13)61048-X.
  6. Padhi S, Ravichandran K, Sahoo J, Varghese RG, Basheer A. Hemophagocytic lymphohistiocytosis: an unusual complication in disseminated mycobacterium tuberculosis. Lung India 2015;32(6):593–601. DOI: 10.4103/0970-2113.168100.
  7. Zemed N, Khatib S, Oualil H, Bourkadi J-E. Secondary hemophagocytic lymphohistiocytosis related to hematopoetic tuberculosis. Egypt J Chest Tuberc 2016;65:365–367. DOI: 10.1016/j.ejcdt.2015.12.013.
  8. Lin TF, Ferlic-Stark LL, Allen CE, Kozinetz CA, McClain KL. Rate of decline of ferritin in patients with hemophagocytic lymphohistiocytosis as a prognostic variable for mortality. Pediatr Blood Cancer 2011;56(1):154–155. DOI: 10.1002/pbc.22774.
  9. Park HS, Kim DY, Lee JH, Lee JH, Kim SD, Park YH, et al. Clinical features of adult patients with secondary hemophagocytic lymphohistiocytosis from causes other than lymphoma: an analysis of treatment outcome and prognostic factors. Ann Hematol 2012;91(6):897–904. DOI: 10.1007/s00277-011-1380-3.
  10. Song KS, Sung HJ. Effect of plasma exhange on circulating IL-6 levels in a patients with fatal hemophagocytic syndrome: two case reports. Ther Apher Dial 2006;10(1):87–89. DOI: 10.1111/j.1744-9987.2006.00347.x.
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