Secondary hemophagocytic lymphohistiocytosis due to miliary tuberculosis: diagnostic challenge and therapeutic dilemma
DOI:
https://doi.org/10.32818/reccmi.a9n2a10Keywords:
hemophagocytic lymphohistiocytosis, pancytopenia, miliary tuberculosis, immune reconstitution inflammatory syndromeAbstract
Hemophagocytic syndrome or lymphohistiocytosis hemophagocytic is a severe syndrome of excessive immune activation. We present a case study of hemophagocytic lymphohistiocytosis with severe pancytopenia due to miliary tuberculosis in a 62-year-old woman. During the antituberculosis treatment, the patient experienced radiological worsening, which was likely due to an immune reconstitution inflammatory syndrome. This case highlights on the importance of considering tuberculosis as a potential trigger and, if suspected, antituberculosis therapy should be initiated early, even in the absence of a definitive diagnosis.
Downloads
Metrics
References
La Rosée P, Horne A, Hines M, von Bahr Greenwood T, Machowicz R, Berliner N, et al. Recommendations for the management of hemophagocytic lym¬phohistiocytosis in adults. Blood 2019; 133: 2465–2477. doi: http://dx.doi. org/10.1182/blood.2018894618 (último acceso jun. 2024). DOI: https://doi.org/10.1182/blood.2018894618
Kim YR, Kim DY. Current status of the diagnosis and treatment of hemopha¬gocytic lymphohistiocytosis in adults. Blood Res. 2021; 56(S1): S17-S25. doi: http://dx.doi.org/10.5045/br.2021.2020323 (último acceso jun. 2024). DOI: https://doi.org/10.5045/br.2021.2020323
Hermans SM, Akkerman OW, Meintjes G, Grobusch MP. Post-tuberculo¬sis treatment paradoxical reactions. Infection. 2024; doi: http://dx.doi. org/10.1007/s15010-024-02310-0 (último acceso jul. 2024). DOI: https://doi.org/10.1007/s15010-024-02310-0
Kurver L, Seers T, van Dorp S, van Crevel R, Pollara G, van Laarhoven A. Tuberculosis-associated hemophagocytic lymphohistiocytosis: Diag¬nostic challenges and determinants of outcome. Open Forum Infect Dis. 2024; 11(4): ofad697. doi: https://academic.oup.com/ofid/article/11/4/ ofad697/7516258 (último acceso jun. 2024). DOI: https://doi.org/10.1093/ofid/ofad697
Zhang Y, Liang G, Qin H, Li Y, Zeng X. Tuberculosis-associated hemophago¬cytic lymphohistiocytosis with initial presentation of fever of unknown ori¬gin in a general hospital: An analysis of 8 clinical cases. Medicine (Baltimore). 2017; 96(16): e6575. doi: http://dx.doi.org/10.1097/md.0000000000006575 (último acceso jun. 2024). DOI: https://doi.org/10.1097/MD.0000000000006575
Mert A, Arslan F, Kuyucu T, Koç EN, Yilmaz M, Turan D, et al. Miliary tuberculo¬sis: epidemiologicaland clinical analysis of large-case series from moderate to low tuberculosis endemic Country. Medicine (Baltimore). 2017; 96(5): e5875. doi: https://pubmed.ncbi.nlm.nih.gov/28151863/ (último acceso jun. 2024). DOI: https://doi.org/10.1097/MD.0000000000005875
Garcia-Gasalla M, Fernández-Baca V, Mir-Viladrich I, Cifuentes-Luna C, Cam¬pins-Roselló A, Payeras-Cifre A, et al. Valor de QuantiFERON-TB Gold Test in Tube en el diagnóstico de tuberculosis pulmonar y extrapulmonar. Enferm Infecc Microbiol Clin. 2010; 28(10): 685–689. doi: http://dx.doi.org/10.1016/j. eimc.2010.01.008 (último acceso jun. 2024). DOI: https://doi.org/10.1016/j.eimc.2010.01.008
Manthri S, Vasireddy NK, Bandaru S, Pathak S. Acquired elliptocytosis as a manifestation of myelodysplastic syndrome associated with deletion of chromosome 20q. Case Rep Hematol. 2018; 2018: 1-3. doi: https://dRi. org/10.1155/2018/6819172 (último acceso jun. 2024). DOI: https://doi.org/10.1155/2018/6819172
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Marina Delgado-Gómez , Marina Muñoz-Hernández, Miguel Ángel Sáez-García, Ana Gómez-Berrocal
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Permite compartir, copiar y redistribuir el material en cualquier medio o formato, bajo los siguientes términos:
Reconocimiento: debe otorgar el crédito correspondiente, proporcionar un enlace a la licencia e indicar si se realizaron cambios. Puede hacerlo de cualquier manera razonable, pero no de ninguna manera que sugiera que el licenciante lo respalda a usted o su uso.
No comercial: no puede utilizar el material con fines comerciales.
No Derivados: si remezcla, transforma o construye sobre el material, no puede distribuir el material modificado.
Sin restricciones adicionales: no puede aplicar términos legales o medidas tecnológicas que restrinjan legalmente a otros de hacer cualquier cosa que permita la licencia.
