title: Hemophagocytic syndrome associated with fulminant hepatitis A: a case report.
abstract: A 37-year-old man had a sore throat and pyrexia since January 1999. He was treated at a nearby hospital, but not improved. Jaundice was indicated there, and the patient was referred transferred to our hospital, where he was admitted for treatment with a diagnosis of severe acute hepatitis with acute renal failure. Thereafter the patient was revealed to have had a past history of heavy drinking, and he underwent the treatment with a diagnosis of acute fulminant hepatitis due to hepatitis A virus (HAV). He showed a tendency toward improvement. During the course, however, viral associated hemophagocytic syndrome (VAHS) developed. Various treatments were conducted, but it was not improved, and the patient died on Hospital Day 66. On pathologic autopsy, remarkable hepatosplenomegaly associated with marked bone marrow abnormalities compatible with VAHS was observed. Aspergillus abscesses were also observed in many organs, and they were considered as an adverse reaction to potent immunosuppressive therapy. Since there have been only a few reports on HAV-related VAHS, discussing VAHS related to HAV, the present case was considered valuable.
authors.affiliation: Department of Internal Medicine, School of Medicine, Keio University, Tokyo, Japan.
authors.forename: Hiromasa
authors.initials: H
authors.lastname: Ishii
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Yamagishi
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Okamoto
authors.forename: Hidetsugu
authors.initials: H
authors.lastname: Saito
authors.forename: Haruhito
authors.initials: H
authors.lastname: Kikuchi
authors.forename: Takahide
authors.initials: T
authors.lastname: Kodama
mesh_terms: D000328:Adult; D017809:Fatal Outcome; D006506:Hepatitis A / Q000150:complications* / Q000276:immunology / Q000473:pathology; D015616:Histiocytosis, Non-Langerhans-Cell / Q000276:immunology / Q000473:pathology / Q000821:virology*; D006801:Humans; D017093:Liver Failure / Q000276:immunology / Q000473:pathology / Q000821:virology*; D008297:Male