Hemophagocytic lymphohistiocytosis (HLH) is an unusual multifaceted clinicopathological entity that often remains misdiagnosed and can be fatal if not timely detected or treated. It can be familial or associated with different types of infections, autoimmune disorders, and malignancies. Parasitic infection-associated HLH has been rarely documented in the literature with only a handful of them being reported due to infection. We describe an extremely rare case of pancytopenia induced by HLH resulting from infection in a 7-year-old girl, which posed as a diagnostic challenge and led to a therapeutic delay.
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http://dx.doi.org/10.4103/tp.TP_44_19 | DOI Listing |
HCA Healthc J Med
December 2024
Oakland University William Beaumont School of Medicine, Rochester Hills, MI.
Background: Hemophagocytic lymphohistiocytosis (HLH) is a non-neoplastic proliferation and macrophage activation that induces cytokine-mediated bone marrow suppression and features of intense phagocytosis in the bone marrow and liver, leading to multi-organ dysfunction and ultimate failure. The diagnosis of HLH in an intensive care setting is challenging, and it is associated with high morbidity and mortality. HLH-94 is the standard protocol for treatment, consisting of dexamethasone and chemotherapy like etoposide.
View Article and Find Full Text PDFZhong Nan Da Xue Xue Bao Yi Xue Ban
July 2024
Department of Endocrinology, First Affiliated Hospital of Army Medical University, Chongqing 400038.
Antithyroid drugs can cause neutropenia or agranulocytosis, rarely pancytopenia in hyperthyroidism therapy. The treatment is difficult and lethality is high when granulocytopenia or pancytopenia combined with hyperthyroidism crisis. First Affiliated Hospital of Army Medical University treated a patient who had pancytopenia caused by methimazole with systemic lupus erythematosus, secondary hyperthyroidism crisis and agranulocytosis.
View Article and Find Full Text PDFCureus
December 2024
Department of Internal Medicine, LewisGale Medical Center, Roanoke, USA.
Pancytopenia is defined as a decrease in all three myeloid cell lines, usually from a precipitating factor such as an autoimmune condition, prescription drug, or several other factors. The etiology of pancytopenia can be determined through laboratory testing, a peripheral blood smear, and a thorough history and physical examination. Trimethoprim-sulfamethoxazole (TMP/SMX, also known by the brand name of Bactrim® or Septra®) is known to cause pancytopenia in rare cases.
View Article and Find Full Text PDFTrans R Soc Trop Med Hyg
January 2025
Department of Infectious Diseases, Kasturba Medical College Manipal, Manipal Academy of higher Education, Manipal, Karnataka, India, 576104.
Burkholderia pseudomallei, the causative agent of melioidosis, is intrinsically resistant to multiple classes of antibiotics and primarily affects immunocompromised individuals, such as those with poorly controlled diabetes or malignancies. In this case, a 58-y-old female farmer with poorly controlled diabetes (HbA1c of 11.4%), metastatic breast cancer with chemotherapy-induced pancytopenia and disseminated melioidosis showed no improvement despite receiving antibiotics and supportive care.
View Article and Find Full Text PDFBMJ Case Rep
December 2024
Haematology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Acute promyelocytic leukaemia (APL) is a highly lethal haematological malignancy. It is rare in pregnancy and may be fatal if not managed promptly and appropriately. A woman in her 20s presented with high-grade fever at 16 weeks of her third pregnancy.
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