Infections associated with haemophagocytic syndrome.
Haemophagocytic syndrome or haemophagocytic lymphohistiocytosis is a rare disease that is often fatal despite treatment. Haemophagocytic syndrome is caused by a dysregulation in natural killer T-cell function, resulting in activation and proliferation of lymphocytes or histiocytes with uncontrolled haemophagocytosis and cytokine overproduction. The syndrome is characterised by fever, hepatosplenomegaly, cytopenias, liver dysfunction, and hyperferritinaemia. Haemophagocytic syndrome can be either primary, with a genetic aetiology, or secondary, associated with malignancies, autoimmune diseases, or infections. Infections associated with haemophagocytic syndrome are most frequently caused by viruses, particularly Epstein-Barr virus (EBV). We present a case of EBV-associated haemophagocytic syndrome in a young adult with no known immunosuppression. We briefly review haemophagocytic syndrome and then discuss its associated infections, particularly EBV and other herpes viruses, HIV, influenza, parvovirus, and hepatitis viruses, as well as bacterial, fungal, and parasitic organisms.
Division of Infectious Diseases, Emory University School of Medicine, Atlanta, GA 30303, USA. nroupha@emory.edu
Nadine G
NG
Rouphael
Naasha J
NJ
Talati
Camille
C
Vaughan
Kelly
K
Cunningham
Roger
R
Moreira
Carolyn
C
Gould
D000328:Adult; D004279:DNA, Viral / Q000032:analysis; D003937:Diagnosis, Differential; D020031:Epstein-Barr Virus Infections / Q000097:blood / Q000175:diagnosis*; D017809:Fatal Outcome; D005260:Female; D005385:Fingers / Q000002:abnormalities*; D006343:Heart Septal Defects; D004854:Herpesvirus 4, Human / Q000235:genetics / Q000302:isolation & purification*; D006801:Humans; D051359:Lymphohistiocytosis, Hemophagocytic / Q000097:blood / Q000175:diagnosis*; D016133:Polymerase Chain Reaction
D004279:DNA, Viral