title: An elderly patient with hemophagocytic syndrome due to severe mycoplasma pneumonia with marked hypercytokinemia.
abstract: We present an extremely rare case of hemophagocytic syndrome (HPS) induced by fulminant Mycoplasma pneumoniae (Mp) pneumonia in an elderly adult. Erythrocytopenia and thrombocytopenia were observed in a patient with acute respiratory failure, liver dysfunction and renal failure. Mp-associated HPS was diagnosed in this case by clinical and laboratory findings, including a bone marrow aspiration specimen and serum Mp antibody titer. High serum levels of soluble interleukin-2 receptor, interleukin-6, human interleukin-10 and macrophage-colony stimulating factor were observed. Hypercytokinemia is a useful marker of disease activity and prognosis. Combined treatment with methylprednisolone and erythromycin was successful and led to a favorable outcome. Physicians should be aware of HPS as a complication in Mp infection.
authors.affiliation: Department of Internal Medicine, National Nagasaki Hospital, Nagasaki, Japan.
authors.forename: Ryusuke
authors.initials: R
authors.lastname: Mizukane
authors.forename: Jun-ichi
authors.initials: J
authors.lastname: Kadota Ji
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Yamaguchi
authors.forename: Takakazu
authors.initials: T
authors.lastname: Kiya
authors.forename: Hiromichi
authors.initials: H
authors.lastname: Fukushima
authors.forename: Masao
authors.initials: M
authors.lastname: Nakatomi
authors.forename: Shigeru
authors.initials: S
authors.lastname: Kohno
mesh_terms: D000368:Aged; D001853:Bone Marrow / Q000473:pathology*; D004359:Drug Therapy, Combination; D004917:Erythromycin / Q000008:administration & dosage; D005500:Follow-Up Studies; D015614:Histiocytosis / Q000150:complications / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage; D009102:Multiple Organ Failure / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D011019:Pneumonia, Mycoplasma / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D012131:Respiratory Insufficiency / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D018570:Risk Assessment; D012720:Severity of Illness Index; D013577:Syndrome; D013921:Thrombocytopenia / Q000150:complications / Q000175:diagnosis*
chemical_list: D004917:Erythromycin; D008775:Methylprednisolone