title: Hemophagocytic lymphohistiocytosis caused by systemic herpes simplex virus type 1 infection: Successful treatment with dexamethasone palmitate.
abstract: Hemophagocytic lymphohistiocytosis (HLH) is a hyperinflammatory condition resulting from an uncontrolled and ineffective immune response. Here, we report a case of HLH caused by disseminated herpes simplex virus (HSV)-1 infection. The patient was initially treated with prednisolone and high-dose acyclovir. Although liver enzymes, coagulation abnormalities, and inflammatory markers were remarkably improved, the platelet count remained low. Prednisolone was therefore switched to dexamethasone palmitate. Thereafter, the platelet count normalized. Inflammatory markers normalized 30 days after admission and serum HSV-DNA became undetectable on day 41. The patient was discharged on day 91 and no developmental delay was evident at 7 months of age. These findings suggest that dexamethasone palmitate is effective for neonatal HLH.
authors.affiliation: Department of Pediatrics, Tokai University School of Medicine, Isehara, Japan.
authors.forename: Keisuke
authors.initials: K
authors.lastname: Otsubo
authors.affiliation: Department of Pediatrics, Tokai University School of Medicine, Isehara, Japan.
authors.forename: Akiko
authors.initials: A
authors.lastname: Fukumura
authors.affiliation: Department of Pediatrics, Tokai University School of Medicine, Isehara, Japan.
authors.forename: Mariko
authors.initials: M
authors.lastname: Hirayama
authors.affiliation: Department of Pediatrics, Tokai University School of Medicine, Isehara, Japan.
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Morimoto
authors.affiliation: Department of Pediatrics, Tokai University School of Medicine, Isehara, Japan.
authors.forename: Masahiko
authors.initials: M
authors.lastname: Kato
authors.affiliation: Department of Pediatrics, Tokai University School of Medicine, Isehara, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Mochizuki
keywords: acyclovir; dexamethasone palmitate; hemophagocytic lymphohistiocytosis; herpes simplex type I