title: Human parechovirus-3 infection in nine neonates and infants presenting symptoms of hemophagocytic lymphohistiocytosis.
abstract: Human parechovirus-3 (HPeV-3) has been reported to cause a sepsis-like illness in neonates and young infants. We experienced the occurrence of HPeV-3 infection in nine neonates and young infants (eight boys, one girl; aged 14-52 days, median 31 days). They were admitted to our hospital with the chief complaints of fever persisting for 3-5 days (median 4 days) and lethargy. Five infants presented with abdominal distension and six had a rash (including acral reddening), as was previously reported with this viral infection. Abdominal distension with navel protrusion and acral reddening during the course were characteristic. Laboratory data were characterized by elevated values for serum AST, LDH, FDP, D-dimer, ferritin, soluble IL-2 receptor, triglyceride, choline esterase, and urinary β(2)-microglobulin. Two of our nine patients presented with a hemophagocytic lymphohistiocytosis (HLH)-like illness and required specific therapy. These data suggest that HPeV-3 is an important virus that can cause hypercytokinemia, which sometimes leads to HLH, and systemic inflammatory response syndrome in neonates and young infants.
authors.affiliation: Department of Pediatrics, Saiseikai Yokohamashi Nanbu Hospital, 3-2-10 Konandai, Konan-ku, Yokohama, Kanagawa, 234-8503, Japan. 99mb1045-thk@umin.ac.jp
authors.forename: Saeko Shimodera
authors.initials: SS
authors.lastname: Yuzurihara
authors.forename: Kota
authors.initials: K
authors.lastname: Ao
authors.forename: Takuma
authors.initials: T
authors.lastname: Hara
authors.forename: Fumiko
authors.initials: F
authors.lastname: Tanaka
authors.forename: Masaaki
authors.initials: M
authors.lastname: Mori
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Kikuchi
authors.forename: Sumio
authors.initials: S
authors.lastname: Kai
authors.forename: Shumpei
authors.initials: S
authors.lastname: Yokota
mesh_terms: D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D051359:Lymphohistiocytosis, Hemophagocytic / Q000175:diagnosis* / Q000503:physiopathology* / Q000821:virology; D008297:Male; D030061:Parechovirus / Q000472:pathogenicity*; D010850:Picornaviridae Infections / Q000175:diagnosis* / Q000503:physiopathology* / Q000821:virology