title: Virus-associated haemophagocytic syndrome caused by rubella in an adult.
abstract: Haemophagocytic syndrome is a systemic clinicopathological entity characterized by systemic proliferation of benign haemophagocytic histiocytes, fever, cytopenia, abnormal liver function and, frequently, coagulopathy and hepatosplenomegaly. Its occurrence has been documented in association with viral, bacterial, fungal and parasitic infections, a wide spectrum of malignant neoplasms, autoimmune diseases and drugs. We report a case of rubella virus-associated haemophagocytic syndrome in a previously healthy 29-year-old woman. Blood tests showed cytopenia, especially severe thrombocytopenia, liver dysfunction, hyperferritinaemia and hypercytokinaemia. Bone marrow examination showed many mature histiocytes with active haemophagocytosis. A skin biopsy from the rash revealed perivascular lymphohistiocytic infiltrates with haemophagocytic histiocytes in the upper and mid-dermis. The patient was treated with antibiotics and immunoglobulin, and by supportive measures including platelet transfusion, and recovered completely.
authors.affiliation: Department of Dermatology, Kyoto Prefectural University of Medicine, Japan. takesan@koto.kpu-m.ac.jp
authors.forename: H
authors.initials: H
authors.lastname: Takenaka
authors.forename: S
authors.initials: S
authors.lastname: Kishimoto
authors.forename: R
authors.initials: R
authors.lastname: Ichikawa
authors.forename: R
authors.initials: R
authors.lastname: Shibagaki
authors.forename: Y
authors.initials: Y
authors.lastname: Kubota
authors.forename: N
authors.initials: N
authors.lastname: Yamagata
authors.forename: H
authors.initials: H
authors.lastname: Gotoh
authors.forename: N
authors.initials: N
authors.lastname: Fujita
authors.forename: H
authors.initials: H
authors.lastname: Yasuno
mesh_terms: D000328:Adult; D001853:Bone Marrow / Q000473:pathology; D005260:Female; D015616:Histiocytosis, Non-Langerhans-Cell / Q000473:pathology / Q000821:virology*; D006801:Humans; D012409:Rubella / Q000150:complications*; D017193:Skin Diseases, Viral / Q000473:pathology / Q000821:virology*