title: Epstein-Barr virus-associated hemophagocytic lymphohistiocytosis during pregnancy.
abstract: An 11-week pregnant, 32-year-old Japanese woman who had recovered from infectious mononucleosis visited our center due to fever, anorexia, and bilateral hypochondrial pain. Blood tests revealed leukopenia, thrombocytopenia and elevated ferritin. She was diagnosed with hemophagocytic lymphohistiocytosis (HLH). A high viral load of the Epstein-Barr virus (EBV) was recognized, indicating EBV-HLH. She was treated with a single dose of dexamethasone to protect the fetus. However, the disease was uncontrollable, necessitating etoposide and cyclosporine administration. Remission was obtained with these medications, and she has remained in remission for the 10 months since completion of chemotherapy. Although the occurrence of EBV-HLH during pregnancy is rare, it is possible that a change in cellular immunity associated with the pregnancy may contribute to EBV-HLH development.
authors.affiliation: Division of Hematology, Japanese Red Cross Medical Center.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Ikeda
authors.forename: Rina
authors.initials: R
authors.lastname: Oba
authors.forename: Yumiko
authors.initials: Y
authors.lastname: Yoshiki
authors.forename: Sumito
authors.initials: S
authors.lastname: Shingaki
authors.forename: Tomomi
authors.initials: T
authors.lastname: Takei
authors.forename: Kanji
authors.initials: K
authors.lastname: Miyazaki
authors.forename: Yu
authors.initials: Y
authors.lastname: Abe
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Tsukada
authors.forename: Tadao
authors.initials: T
authors.lastname: Ishida
authors.forename: Kenshi
authors.initials: K
authors.lastname: Suzuki
mesh_terms: D000328:Adult; D016572:Cyclosporine / Q000008:administration & dosage / Q000627:therapeutic use*; D020031:Epstein-Barr Virus Infections / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D005047:Etoposide / Q000008:administration & dosage / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007244:Infectious Mononucleosis / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D051359:Lymphohistiocytosis, Hemophagocytic / Q000175:diagnosis / Q000188:drug therapy* / Q000276:immunology; D011247:Pregnancy; D016896:Treatment Outcome
chemical_list: D005047:Etoposide; D016572:Cyclosporine