title: Virological and immunological characteristics of fatal virus-associated haemophagocytic syndrome (VAHS).
abstract: We report three infants and one teenager with fatal virus-associated haemophagocytic syndrome (VAHS). Two infants were admitted to our hospital because of cardio-pulmonary arrest (CPA). The third infant was admitted to our department because of fever and liver dysfunction, and he was diagnosed as combined immunodeficiency with predominant T cell defect. The teenager was diagnosed as systemic lupus erythema (SLE) when she was 10 years old and admitted to our department because of fever and thrombocytopenia . The histological findings for the four patients' organs revealed many haemophagocytic cells . The patients were infected by Parainfluenza virus type 2 (PIV2), Enterovirus (EV), Cytomegalovirus (CMV), and Epstein-Barr virus (EBV), respectively. Their laboratory data revealed elevated levels of ferritin and IL-6, which also suggested virus-associated haemophagocytic syndrome (VAHS). Although aggressive therapies were performed in all cases, the outcome was fatal. Further investigation would be needed to clarify the mechanism of VAHS and an effective therapeutic regimen is needed.
authors.affiliation: Department of Pediatrics, Tokyo Medical University, Japan. hoyohoyo@tokyo-med.ac.jp
authors.forename: Yasuyo
authors.initials: Y
authors.lastname: Kashiwagi
authors.forename: Hisashi
authors.initials: H
authors.lastname: Kawashima
authors.forename: Satoshi
authors.initials: S
authors.lastname: Sato
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Ioi
authors.forename: Masahiro
authors.initials: M
authors.lastname: Amaha
authors.forename: Kouji
authors.initials: K
authors.lastname: Takekuma
authors.forename: Akinori
authors.initials: A
authors.lastname: Hoshika
authors.forename: Hisashi
authors.initials: H
authors.lastname: Oshiro
authors.forename: Jun
authors.initials: J
authors.lastname: Matsubayashi
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Mukai
mesh_terms: D000293:Adolescent; D001853:Bone Marrow / Q000473:pathology; D003587:Cytomegalovirus / Q000302:isolation & purification; D004770:Enterovirus / Q000302:isolation & purification; D004769:Enterovirus Infections / Q000276:immunology / Q000473:pathology* / Q000503:physiopathology; D017809:Fatal Outcome; D005260:Female; D005293:Ferritins / Q000097:blood; D006566:Herpesviridae Infections / Q000276:immunology / Q000473:pathology / Q000821:virology; D004854:Herpesvirus 4, Human / Q000302:isolation & purification; D006801:Humans; D007223:Infant; D015850:Interleukin-6 / Q000097:blood; D007668:Kidney / Q000473:pathology; D008099:Liver / Q000473:pathology; D008168:Lung / Q000473:pathology; D051359:Lymphohistiocytosis, Hemophagocytic / Q000276:immunology* / Q000473:pathology / Q000821:virology*; D008297:Male; D010223:Parainfluenza Virus 2, Human / Q000302:isolation & purification; D019351:Rubulavirus Infections / Q000276:immunology / Q000473:pathology / Q000503:physiopathology
chemical_list: D015850:Interleukin-6; D005293:Ferritins