Virus associated hemophagocytic syndrome accompanied by acute respiratory failure caused by influenza A (H3N2).
A 40-year-old Japanese woman was admitted to Oita University Hospital with progressive dyspnea, consciousness disturbance and severe cytopenias. Her chest roentgenogram showed diffuse bilateral infiltrates. She was therefore forced to receive mechanical ventilation. Bone marrow aspiration disclosed numerous hemophagocytic histiocytes, thus suggesting her condition to be hemophagocytic syndrome. In addition, she also developed myocarditis and renal failure. Pulsed methylprednisolone, gamma-globulin, granulocyte colony-stimulating factor and sivelestat sodium hydrate were administrated, and thereafter the patient recovered from cytopenia and organ failure. Afterwards, influenza A H3N2 was detected from bronchial extracts. We should recognize that an influenza A virus infection can induce hemophagocytic syndrome and acute respiratory failure as the initial manifestations of multiple organ failure.
Ando
Masaru
M
Division of Pulmonary Disease, Oita University Faculty of Medicine.
Miyazaki
Eishi
E
Hiroshige
Shigeo
S
Ashihara
Yoshinori
Y
Okubo
Toshiyuki
T
Ueo
Mami
M
Fukami
Tetsujiro
T
Sugisaki
Katsunori
K
Tsuda
Tomiyasu
T
Ohishi
Kazunari
K
Yoshitake
Shigenori
S
Noguchi
Takayuki
T
Kumamoto
Toshihide
T
D058186:Acute Kidney Injury / Q000209:etiology; D000328:Adult; D000914:Antibodies, Viral / Q000097:blood; D001980:Bronchi / Q000821:virology; D002277:Carcinoma / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery; D003131:Combined Modality Therapy; D005260:Female; D005998:Glycine / Q000031:analogs & derivatives / Q000627:therapeutic use; D016179:Granulocyte Colony-Stimulating Factor / Q000627:therapeutic use; D006801:Humans; D016867:Immunocompromised Host; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D053122:Influenza A Virus, H3N2 Subtype / Q000276:immunology / Q000302:isolation & purification*; D007251:Influenza, Human / Q000150:complications* / Q000821:virology; D051359:Lymphohistiocytosis, Hemophagocytic / Q000188:drug therapy / Q000209:etiology*; D008775:Methylprednisolone / Q000627:therapeutic use; D009205:Myocarditis / Q000209:etiology; D011183:Postoperative Complications / Q000821:virology; D012121:Respiration, Artificial; D012131:Respiratory Insufficiency / Q000209:etiology* / Q000628:therapy; D013449:Sulfonamides / Q000627:therapeutic use; D014062:Tongue Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery; D005719:gamma-Globulins / Q000627:therapeutic use
D000914:Antibodies, Viral; D007166:Immunosuppressive Agents; D013449:Sulfonamides; D005719:gamma-Globulins; D016179:Granulocyte Colony-Stimulating Factor; C069195:sivelestat; D005998:Glycine; D008775:Methylprednisolone