Hepatitis A causing a second episode of virus-associated haemophagocytic lymphohistiocytosis in a patient with Still's disease.
A 20-year-old female with Still's disease who had contracted hepatitis A became critically ill 2 weeks after the onset of jaundice with pancytopenia, coagulopathy, deteriorating liver function tests, and hepatomegaly. The diagnosis of virus-associated haemophagocytic lymphohistiocytosis was made, and she improved slowly after supportive treatment with parenteral steroids and immunoglobulin. Twelve years earlier, at the onset of her arthritis, she had suffered a similar episode of haemophagocytic lymphohistiocytosis in association with Epstein-Barr virus infection.
McPeake
J R
JR
Institute of Liver Studies, King's College Hospital, London, England.
Hirst
W J
WJ
Brind
A M
AM
Williams
R
R
D000328:Adult; D001171:Arthritis, Juvenile / Q000150:complications*; D005260:Female; D006506:Hepatitis A / Q000150:complications*; D015616:Histiocytosis, Non-Langerhans-Cell / Q000150:complications / Q000188:drug therapy / Q000209:etiology*; D006801:Humans; D012008:Recurrence