Reactive haemophagocytic lymphohistiocytosis.
We present a series of five cases diagnosed and treated as reactive haemophagocytic lymphohistiocytosis (HLH) in three tertiary referral centers of Kolkata, within a time frame of 3 months. The initial presentations were very variable, the most prominent clinical feature being--acute renal failure in the first patient, convulsions in the second, encephalopathy the third, marked cervical lymphadenopathy in the fourth and polyserositis in the fifth. All had a history of prolonged fever preceding admission and hepatosplenomegaly on examination. Investigations revealed multi-organ involvement with pancytopenia; haemophagocytosis was eventually diagnosed by bone marrow examination. These cases highlight the diagnostic challenge posed by infection associated haemophagocytosis and the need for maintaining a high index of suspicion to promptly diagnose and treat this potentially life threatening condition.
Pramanik
Shanto
S
Institute of Child Health, Kolkata, India.
Pal
Priyankar
P
Das
P K
PK
Chakrabarty
Subroto
S
Bhattacharya
Arpita
A
Banerjee
Sushmita
S
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001853:Bone Marrow / Q000473:pathology*; D001856:Bone Marrow Examination; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D005260:Female; D005335:Fever of Unknown Origin; D006529:Hepatomegaly / Q000175:diagnosis / Q000209:etiology; D006801:Humans; D051359:Lymphohistiocytosis, Hemophagocytic / Q000175:diagnosis* / Q000188:drug therapy; D008297:Male; D013163:Splenomegaly / Q000175:diagnosis / Q000209:etiology; D013256:Steroids / Q000627:therapeutic use
D000900:Anti-Bacterial Agents; D013256:Steroids