Hemophagocytic syndrome secondary to tuberculosis at 24-week gestation.
Hemophagocytic syndrome is a life-threatening disease characterized by the uncontrolled activation of macrophages, resulting in hemophagocytosis of blood cells in the bone marrow. A 20-year-old gravida at 23-week and 5-day gestation was admitted to hospital to evaluate fever up to 104°F of unknown origin, moderate cytopenia, and elevated levels of liver enzymes. Bone marrow biopsy confirmed hemophagocytic syndrome, and polymerase chain reaction came back positive for Mycobacterium tuberculosis. Supportive care and tuberculosis treatment resulted in clinical improvement. At 27 weeks and 5 days, premature rupture of the membranes occurred, and because of the high probability of reactivating the hemophagocytic syndrome, a cesarean section was performed at 29-week and 2-day gestation. Hemophagocytic syndrome is an uncommon disease which rarely appears during pregnancy. Early diagnosis and treatment can save both maternal and fetal lives.
Department of Obstetrics and Gynecology, Virgen de la Salud Hospital, Toledo, Spain.
Alexandra Arteaga
AA
Fernández
Department of Internal Medicine, Fundación Alcorcón Universitary Hospital, Alcorcón, Madrid, Spain.
David Fernández
DF
de Velasco Pérez
Department of Obstetrics and Gynecology, Virgen de la Salud Hospital, Toledo, Spain.
M C Jiménez
MC
Fournier
Department of Obstetrics and Gynecology, Virgen de la Salud Hospital, Toledo, Spain.
J C
JC
Moreno Del Prado
Department of Obstetrics and Gynecology, Virgen de la Salud Hospital, Toledo, Spain.
B Paraíso
BP
Torras
Department of Obstetrics and Gynecology, Virgen de la Salud Hospital, Toledo, Spain.
M L
ML
Cañete Palomo
D002585:Cesarean Section; D005260:Female; D005334:Fever; D006801:Humans; D007231:Infant, Newborn; D007362:Intensive Care Units; D051359:Lymphohistiocytosis, Hemophagocytic / Q000175:diagnosis* / Q000209:etiology* / Q000382:microbiology; D009169:Mycobacterium tuberculosis / Q000235:genetics / Q000302:isolation & purification*; D016133:Polymerase Chain Reaction; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious; D014376:Tuberculosis / Q000150:complications* / Q000382:microbiology; D055815:Young Adult