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Hemophagocytic lymphohistiocytosis associated with SFTS virus infection: A case report with literature review.

Oh HS, Kim M, Lee JO, Kim H, Kim ES, Park KU, Kim HB, Song KH - Medicine (Baltimore) (2016)

Bottom Line: We decided to confirm its histologic feature for sure.A definitive diagnosis was SFTS-associated HLH.In certain endemic areas, SFTS infection deserves clinicians' attention because it can be presented hematologic diseases as HLH.

View Article: PubMed Central - PubMed

Affiliation: aDepartment of Internal Medicine bDepartment of Laboratory Medicine cDepartment of Pathology, Seoul National University Bundang Hospital, Seongnam, South Korea.

ABSTRACT

Background: Severe fever with thrombocytopenia syndrome (SFTS) is a new emerging zoonosis. Hemophagocytic lymphohistiocytosis (HLH) is a life-threatening syndrome caused by hyperinflammation. Here, we report the case of SFTS-associated HLH.

Case summary: A 62-year-old man was admitted to local hospital with 8 days of fever and chill. He had leukopenia, thrombocytopenia, and developed seizure. An attending physician examined bone marrow to rule out hematologic malignancy. He was transferred to tertiary referral hospital for suspicious HLH. We decided to confirm its histologic feature for sure. Bone marrow and liver biopsy showed hemophagocyotic histiocytes. Serological tests for other infections were all negative except SFTS virus polymerase chain reactions (PCRs) as positive from serum, bone marrow, bronchoalveolar lavage fluid, and liver biopsy specimen. A definitive diagnosis was SFTS-associated HLH. During 2 weeks of conservative treatment, he succeeded in recovery from multiple organ failure.

Conclusion: SFTS should be considered one of differential diagnosis of HLH. In certain endemic areas, SFTS infection deserves clinicians' attention because it can be presented hematologic diseases as HLH.

No MeSH data available.


Related in: MedlinePlus

(A) Liver biopsy showing mild steatosis and mild lobular inflammation with acidophilic bodies (arrow: original magnification ×100, hematoxylin-eosin stain). (B) A few erythrophagocytic histiocytes (arrow) can be seen in sinusoids (original magnification ×400, hematoxylin-eosin stain).
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Figure 2: (A) Liver biopsy showing mild steatosis and mild lobular inflammation with acidophilic bodies (arrow: original magnification ×100, hematoxylin-eosin stain). (B) A few erythrophagocytic histiocytes (arrow) can be seen in sinusoids (original magnification ×400, hematoxylin-eosin stain).

Mentions: Bone marrow examination revealed hemophagocytic histiocytes. Examination of the liver biopsy specimen showed that the liver was mildly steatotic and there was mild lobular inflammation with a few acidophilic bodies in the lobular parenchyma (Fig. 2A). Higher power magnification revealed a few erythrophagocytic histiocytes in the sinusoids (Fig. 2B). There was no evidence of abnormal neoplastic cell infiltration in either the bone morrow or liver biopsy specimens. SFTS virus polymerase chain reaction (PCR) using serum, bone marrow, bronchoalveolar lavage (BAL) fluid analysis, and liver biopsy specimens were positive. Other bacteriologic culture, serologic, and molecular tests for possible infectious causes gave negative findings or referred to past infections.


Hemophagocytic lymphohistiocytosis associated with SFTS virus infection: A case report with literature review.

Oh HS, Kim M, Lee JO, Kim H, Kim ES, Park KU, Kim HB, Song KH - Medicine (Baltimore) (2016)

(A) Liver biopsy showing mild steatosis and mild lobular inflammation with acidophilic bodies (arrow: original magnification ×100, hematoxylin-eosin stain). (B) A few erythrophagocytic histiocytes (arrow) can be seen in sinusoids (original magnification ×400, hematoxylin-eosin stain).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4979843&req=5

Figure 2: (A) Liver biopsy showing mild steatosis and mild lobular inflammation with acidophilic bodies (arrow: original magnification ×100, hematoxylin-eosin stain). (B) A few erythrophagocytic histiocytes (arrow) can be seen in sinusoids (original magnification ×400, hematoxylin-eosin stain).
Mentions: Bone marrow examination revealed hemophagocytic histiocytes. Examination of the liver biopsy specimen showed that the liver was mildly steatotic and there was mild lobular inflammation with a few acidophilic bodies in the lobular parenchyma (Fig. 2A). Higher power magnification revealed a few erythrophagocytic histiocytes in the sinusoids (Fig. 2B). There was no evidence of abnormal neoplastic cell infiltration in either the bone morrow or liver biopsy specimens. SFTS virus polymerase chain reaction (PCR) using serum, bone marrow, bronchoalveolar lavage (BAL) fluid analysis, and liver biopsy specimens were positive. Other bacteriologic culture, serologic, and molecular tests for possible infectious causes gave negative findings or referred to past infections.

Bottom Line: We decided to confirm its histologic feature for sure.A definitive diagnosis was SFTS-associated HLH.In certain endemic areas, SFTS infection deserves clinicians' attention because it can be presented hematologic diseases as HLH.

View Article: PubMed Central - PubMed

Affiliation: aDepartment of Internal Medicine bDepartment of Laboratory Medicine cDepartment of Pathology, Seoul National University Bundang Hospital, Seongnam, South Korea.

ABSTRACT

Background: Severe fever with thrombocytopenia syndrome (SFTS) is a new emerging zoonosis. Hemophagocytic lymphohistiocytosis (HLH) is a life-threatening syndrome caused by hyperinflammation. Here, we report the case of SFTS-associated HLH.

Case summary: A 62-year-old man was admitted to local hospital with 8 days of fever and chill. He had leukopenia, thrombocytopenia, and developed seizure. An attending physician examined bone marrow to rule out hematologic malignancy. He was transferred to tertiary referral hospital for suspicious HLH. We decided to confirm its histologic feature for sure. Bone marrow and liver biopsy showed hemophagocyotic histiocytes. Serological tests for other infections were all negative except SFTS virus polymerase chain reactions (PCRs) as positive from serum, bone marrow, bronchoalveolar lavage fluid, and liver biopsy specimen. A definitive diagnosis was SFTS-associated HLH. During 2 weeks of conservative treatment, he succeeded in recovery from multiple organ failure.

Conclusion: SFTS should be considered one of differential diagnosis of HLH. In certain endemic areas, SFTS infection deserves clinicians' attention because it can be presented hematologic diseases as HLH.

No MeSH data available.


Related in: MedlinePlus