title: Cytomegalovirus-Induced Hemophagocytic Lymphohistiocytosis in an Extreme Preterm Infant: Recognition and Therapy Leading to Recovery.
abstract: BACKGROUND
  Hemophagocytic lymphohistiocytosis (HLH) is a rare disease that can be triggered by cytomegalovirus, a relatively common infectious exposure to neonates. The clinical presentation is common to many acute illnesses seen in extreme premature infants; however, there are key clinical and laboratory findings that can lead to the diagnosis.
  
  
  OBJECTIVE
  We present a case of an extreme premature infant of 25 weeks' gestation who developed cytomegalovirus-induced HLH. Using the current published protocols that are used in pediatric cancer can be adapted for use in a premature infant, which led to remission of HLH and eventual discharge from the neonatal intensive care unit.
  
  
  CONCLUSIONS
  There are published treatment protocols used in pediatric oncology that when initiated early can lead to favorable outcomes and remission in even the most fragile neonates.
  
  
  CONCLUSIONS
  Additional studies are needed on the pharmacokinetics, dosing, and side effects on medications used for treatment of HLH in preterm infants. Additional research is needed to improve the clinician's ability to reach the diagnosis as well as define treatment strategies that provide optimal outcomes.
authors: Department of Pediatrics, Medical University of South Carolina, Charleston.
authors: Matthew
authors: M
authors: Halliday
authors: Julie
authors: J
authors: Ross
authors: W Michael
authors: WM
authors: Southgate
mesh_terms: D000972:Antineoplastic Agents, Phytogenic / Q000627:therapeutic use*; D000998:Antiviral Agents / Q000627:therapeutic use*; D001853:Bone Marrow / Q000473:pathology; D016572:Cyclosporine / Q000627:therapeutic use; D003586:Cytomegalovirus Infections / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D003907:Dexamethasone / Q000627:therapeutic use; D005047:Etoposide / Q000627:therapeutic use; D015774:Ganciclovir / Q000031:analogs & derivatives / Q000627:therapeutic use; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D007223:Infant; D062071:Infant, Extremely Premature; D007231:Infant, Newborn; D007694:Killer Cells, Natural; D051359:Lymphohistiocytosis, Hemophagocytic / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D008297:Male; D015375:Receptors, Interleukin-2 / Q000097:blood; D016896:Treatment Outcome; D000077562:Valganciclovir
chemical_list: D000972:Antineoplastic Agents, Phytogenic; D000998:Antiviral Agents; D005938:Glucocorticoids; D007166:Immunosuppressive Agents; D015375:Receptors, Interleukin-2; D005047:Etoposide; D003907:Dexamethasone; D016572:Cyclosporine; D000077562:Valganciclovir; D015774:Ganciclovir