title: Secondary hemophagocytic lymphohistiocytosis (HLH) from a presumed brown recluse spider bite.
abstract: Systemic loxoscelism is a rare complication after Loxosceles reclusa (brown recluse spider) envenomation. Loxosceles venom contains pro-inflammatory proteins, which have been shown to be elevated in patients with hemophagocytic lymph histiocytosis. We present a case of a 10-year-old male that developed presumed systemic loxoscelism, secondary hemophagocytic lymphohistiocytosis with hepatic dysfunction and renal failure. He was treated with dexamethasone and made a full recovery.
authors.affiliation: Department of Pediatrics, Division of Bone Marrow Transplant and Immune Deficiency, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, MLC 7015, 45229, Cincinnati, OH, USA, christopher.dandoy@cchmc.org.
authors.forename: Christopher
authors.initials: C
authors.lastname: Dandoy
authors.forename: Michael
authors.initials: M
authors.lastname: Grimley
mesh_terms: D000818:Animals; D063287:Brown Recluse Spider; D002648:Child; D003907:Dexamethasone / Q000627:therapeutic use; D005938:Glucocorticoids / Q000627:therapeutic use; D048550:Hepatic Insufficiency / Q000188:drug therapy / Q000209:etiology / Q000276:immunology* / Q000473:pathology; D006801:Humans; D007299:Insect Bites and Stings / Q000150:complications / Q000188:drug therapy / Q000276:immunology* / Q000473:pathology; D051359:Lymphohistiocytosis, Hemophagocytic / Q000188:drug therapy / Q000209:etiology / Q000276:immunology* / Q000473:pathology; D008297:Male; D010727:Phosphoric Diester Hydrolases / Q000276:immunology*; D051437:Renal Insufficiency / Q000188:drug therapy / Q000209:etiology / Q000276:immunology* / Q000473:pathology; D013111:Spider Venoms / Q000276:immunology*; D016896:Treatment Outcome
chemical_list: D005938:Glucocorticoids; D013111:Spider Venoms; C055161:loxosceles venom; D003907:Dexamethasone; D010727:Phosphoric Diester Hydrolases
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