title: Atypical hemophagocytic lymphohistiocytosis following bacterial tonsillitis in acute lymphoblastic leukemia.
abstract: We report a rare case of a cute lymphoblasticleukemia (ALL) who developed dyspnea, neurological disturbance with illusions, pancytopenia, phagocytosis and coagulation disturbances following bacterial tonsillitis. The values of soluble interleukin-2 receptor (sIL-2R), IL-6 and IL-8 were also elevated. Her clinicolaboratory findings were similar to hemophagocytic lymphohistiocytosis (HLH), which is a cytokine disease induced by activated T cells and macrophages. Atypical HLH following bacterial tonsillitis should be kept in mind in leukemia patients.
authors.affiliation: Department of Homeostatic Regulation and Development, Division of Pediatrics, Niigata University Graduate School of Medical and Dental Sciences, Asahimachi-dori 1, Niigata, 951-8510, Japan. shounika@med.niigata-u.ac.jp
authors.forename: Toshio
authors.initials: T
authors.lastname: Kakihara
authors.forename: Chihaya
authors.initials: C
authors.lastname: Imai
authors.forename: Takayuki
authors.initials: T
authors.lastname: Kaneko
authors.forename: Atsushi
authors.initials: A
authors.lastname: Tanaka
authors.forename: Makoto
authors.initials: M
authors.lastname: Uchiyama
mesh_terms: D015703:Antigens, CD / Q000378:metabolism; D000970:Antineoplastic Agents; D001777:Blood Coagulation; D002648:Child; D004417:Dyspnea / Q000209:etiology; D005260:Female; D015616:Histiocytosis, Non-Langerhans-Cell / Q000382:microbiology*; D006801:Humans; D015850:Interleukin-6 / Q000378:metabolism; D016209:Interleukin-8 / Q000378:metabolism; D010198:Pancytopenia / Q000209:etiology; D010587:Phagocytosis; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000150:complications* / Q000188:drug therapy / Q000473:pathology; D011552:Pseudomonas Infections / Q000382:microbiology*; D011550:Pseudomonas aeruginosa / Q000472:pathogenicity; D015375:Receptors, Interleukin-2 / Q000378:metabolism; D013290:Streptococcal Infections / Q000382:microbiology*; D014069:Tonsillitis / Q000382:microbiology*
chemical_list: D015703:Antigens, CD; D000970:Antineoplastic Agents; D015850:Interleukin-6; D016209:Interleukin-8; D015375:Receptors, Interleukin-2