Histiocytic haemophagocytosis in a patient with Kawasaki disease: changes in the hypercytokinaemic state.
A 32-month-old Japanese boy exhibited haemophagocytic syndrome (HPS) during the recurrent course of Kawasaki disease. Despite repeated gamma-globulin therapy, he developed cytopenia with marked hepatomegaly and evidence of histiocytic haemophagocytosis in the bone marrow. Serum levels of interferon-gamma and tumour necrosis factor, but not of interleukin-1 beta, increased in parallel with his symptoms. No confirmation was obtained of the association of toxic reactions to the used drugs. No coronary lesions remained as sequelae.


CONCLUSIONS
Cytopenia in Kawasaki disease could herald HPS, and the hypercytokinaemia involved in the two febrile syndromes might be of distinct nature.
Ohga
S
S
Department of Paediatrics, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
Ooshima
A
A
Fukushige
J
J
Ueda
K
K
D002675:Child, Preschool; D016207:Cytokines / Q000097:blood*; D015616:Histiocytosis, Non-Langerhans-Cell / Q000276:immunology*; D006801:Humans; D007371:Interferon-gamma / Q000097:blood; D007375:Interleukin-1 / Q000097:blood; D008213:Lymphocyte Activation / Q000276:immunology; D008297:Male; D009080:Mucocutaneous Lymph Node Syndrome / Q000276:immunology*; D012008:Recurrence; D013601:T-Lymphocytes / Q000276:immunology; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism
D016207:Cytokines; D007375:Interleukin-1; D014409:Tumor Necrosis Factor-alpha; D007371:Interferon-gamma