Epstein-Barr virus-associated haemophagocytic lymphohistiocytosis in Wiskott-Aldrich syndrome.
A patient with Wiskott-Aldrich syndrome who developed Epstein-Barr virus-associated haemophagocytic lymphohistiocytosis (EBV-HLH) is described in this study. At 4 mo of age the patient developed fever associated with bicytopenia and splenomegaly. Analysis of a bone marrow specimen revealed extensive haemophagocytosis, and in situ hybridization for EBV of the bone marrow specimen using an EBV-encoded RNA probe was positive. Diagnosis of EBV-HLH was established and immunotherapy with HLH-94 protocol was started. HLH has been described in patients with other well-defined primary immunodeficiencies such as X-linked lymphoproliferative syndrome, Chediak-Higashi syndrome and Griscelli disease. Also, HLH was reported recently in severe combined immunodeficiency and DiGeorge syndrome.


CONCLUSIONS
The possibility of an underlying primary immunodeficiency should be considered in paediatric patients who present with HLH during infancy.
Pasic
S
S
Department of Paediatric Immunology, Mother and Child Health Institute, Belgrade, Yugoslavia. bg.pasic@eunet.yu
Micic
D
D
Kuzmanovic
M
M
D002675:Child, Preschool; D020031:Epstein-Barr Virus Infections / Q000188:drug therapy / Q000276:immunology / Q000821:virology*; D006529:Hepatomegaly / Q000150:complications; D015616:Histiocytosis, Non-Langerhans-Cell / Q000150:complications* / Q000821:virology*; D006801:Humans; D007070:Immunoglobulin A / Q000276:immunology; D007074:Immunoglobulin G / Q000276:immunology; D007075:Immunoglobulin M / Q000276:immunology; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D008297:Male; D013163:Splenomegaly / Q000150:complications; D014923:Wiskott-Aldrich Syndrome / Q000150:complications*
D007070:Immunoglobulin A; D007074:Immunoglobulin G; D007075:Immunoglobulin M; D016756:Immunoglobulins, Intravenous