Pregnancy-induced hemophagocytic lymphohistiocytosis combined with autoimmune hemolytic anemia.
Hemophagocytic lymphohistiocytosis (HLH), presenting with fever, cytopenia, liver dysfunction, hepatosplenomegaly, hypertriglyceridemia, and hyperferritinemia, is associated with various etiologies, including infections, collagen vascular diseases, and malignancies. The present report describes a 28-year-old woman who developed HLH combined with autoimmune hemolytic anemia (AIHA) at 23 weeks of gestation. Without response to corticosteroid, the patient completely recovered from both HLH and AIHA after termination of the pregnancy. Pregnancy-induced immune dysregulation and cytokine overproduction in genetically susceptible women may play critical roles in HLH. The differential diagnosis of pregnant women with fever and cytopenia should include HLH. Pregnancy termination should be considered when pregnancy-induced HLH is refractory to medical treatment.
Teng
Chieh-Lin
CL
Department of Medicine, Taichung Veterans General Hospital, Taichung, Taiwan, Republic of China. drteng@vghtc.gov.tw
Hwang
Guang-Yuh
GY
Lee
Bor-Jen
BJ
Wang
Ren-Ching
RC
Chou
Ming-Ming
MM
D000328:Adult; D000744:Anemia, Hemolytic, Autoimmune / Q000209:etiology*; D005260:Female; D006801:Humans; D051359:Lymphohistiocytosis, Hemophagocytic / Q000209:etiology*; D011247:Pregnancy; D011248:Pregnancy Complications; D011250:Pregnancy Complications, Hematologic