Tuberculosis-associated hemophagocytic lymphohistiocytosis in adolescent diagnosed by polymerase chain reaction.
- Author:
Ju Hee SEO
1
;
Jun Ah LEE
;
Dong Ho KIM
;
Joongbum CHO
;
Jung Sub LIM
Author Information
- Publication Type:Case Report
- Keywords: Hemophagocytic lymphohistiocytosis; Adolescent; Tuberculosis; Polymerase chain reaction
- MeSH: Adolescent*; Biopsy; Blood Cells; Bone Marrow; Dexamethasone; Diagnosis; Fatigue; Female; Fever; Histiocytes; Humans; Hypertriglyceridemia; Immunoglobulins; Lymphatic Diseases; Lymphohistiocytosis, Hemophagocytic*; Mycobacterium tuberculosis; Pancytopenia; Polymerase Chain Reaction*; Sputum; Survival Rate; Tuberculosis; Weight Loss
- From:Korean Journal of Pediatrics 2016;59(1):43-46
- CountryRepublic of Korea
- Language:English
- Abstract: We present a case of tuberculosis-associated hemophagocytic lymphohistiocytosis in a 14-year-old girl. The patient presented with weight loss, malaise, fatigue, prolonged fever, and generalized lymphadenopathy. Laboratory investigation revealed pancytopenia (white blood cells, 2,020 cells/microL; hemoglobin, 10.2 g/dL; platelets, 52,000 cells/microL), hypertriglyceridemia (229 mg/dL), and hyperferritinemia (1,420 ng/mL). Bone marrow biopsy showed a hypocellular bone marrow with a large numbers of histiocytes and marked hemophagocytosis; based on these findings, she was diagnosed with hemophagocytic lymphohistiocytosis. Polymerase chain reaction (PCR) with both the bone marrow aspiration and sputum samples revealed the presence of Mycobacterium tuberculosis. Antitubercular therapy with immune modulation therapy including dexamethasone and intravenous immunoglobulin was initiated. The results of all laboratory tests including bone marrow biopsy and PCR with both the bone marrow aspiration and sputum samples were normalized after treatment. Thus, early bone marrow biopsy and the use of techniques such as PCR can avoid delays in diagnosis and improve the survival rates of patients with tuberculosis-associated hemophagocytic lymphohistiocytosis.
