title: Novel influenza A (H1N1) virus-induced hemophagocytosis: first case reported in Saudi Arabia.
abstract: H1N1 is a novel subtype of the influenza A virus. Since its reemergence in 2008, it has been reported to cause a variety of illnesses ranging from mild flu-like symptoms to severe multiorgan failure. We report a case of a young immunocompetent man who presented with progressive shortness of breath and rapidly developed multiorgan dysfunction, including pancytopenia from H1N1 infection during the 2010-2011 influenza season. His H1N1 pneumonia caused severe acute respiratory distress syndrome, respiratory failure requiring mechanical ventilation, rhabdomyolysis, myocarditis, hepatitis, encephalitis, and renal failure. During the diagnostic workup, a bone marrow biopsy was performed, showing hemophagocytosis secondary to the H1N1 infection. Unfortunately the patient died despite aggressive measures. Published reports contain only a few records of H1N1-induced hemophagocytosis. This is the first case report from Saudi Arabia with H1N1-induced secondary hemophagocytosis. It also highlights the fact that the virus is still very virulent and will pose a major annual health risk along with the seasonal influenza for at least the next few years.
authors.affiliation: Department of Haematology, Medicine and Haematopathology, King Faisal Specialist Hospital and Research Centre, Jeddah, Saudi Arabia.
authors.forename: Jalil
authors.initials: J
authors.lastname: Ur Rehman
authors.forename: Ghassan
authors.initials: G
authors.lastname: Wali
authors.forename: Najla M
authors.initials: NM
authors.lastname: Sayes
authors.forename: Abdulghani
authors.initials: A
authors.lastname: Maulawi
authors.forename: Mohammad
authors.initials: M
authors.lastname: Aslam
authors.forename: Imran
authors.initials: I
authors.lastname: Khalid
mesh_terms: D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use; D017809:Fatal Outcome; D006801:Humans; D053118:Influenza A Virus, H1N1 Subtype; D007251:Influenza, Human / Q000150:complications* / Q000188:drug therapy; D008297:Male; D009102:Multiple Organ Failure / Q000150:complications*; D053139:Oseltamivir / Q000627:therapeutic use; D012128:Respiratory Distress Syndrome / Q000150:complications*; D012529:Saudi Arabia
chemical_list: D000998:Antiviral Agents; D053139:Oseltamivir