Title: Dengue with Hemophagocytic Lymphohistiocytosis-Rare Presentation
Authors: Dr Shweta Nair, Dr Abir Lal Nath, Dr Rajdeep Pal
DOI: http://dx.doi.org/10.18535/jmscr/v3i12.27
Abstract
A 1 and a half-year-old female child presented with fever, cough and cold since 2 weeks. Investigations revealed Dengue IgG, IgM Positive with pancytopenia and diagnosed to have HLH on bone marrow examination in view of unusual course. She was managed symptomatically along with antibiotics for associated urinary tract infection. It has not been reported in literature earlier.
Hemophagocytic Lymphohistiocytosis (HLH) is a rare macrophage related hyper inflammatory disorder that presents as prolonged fever and a sepsis like syndrome. It is a rare and life threatening complication of dengue.
KEYWORDS: Dengue, Hemophagocytic lymphohistiocytosis, pancytopenia
References
1. Loy T, Alberto AD, Perry MC. Familial erythrophagocytic lymphohistiocytosis. Semin Oncol. 1991; 18:34-9.
2. Janka G, Elinder G, Imashuku S, Schneider M, Henter J. Infection- and malignancy-associated hemophagocytic syndromes: secondary hemophagocyticl-ymphohistiocytosis. Hematol OncolClin North Am. 1998; 12:435-44.
3. Fisman DN. Hemophagocytic syndromes and infection. Emerg Infect Dis 2000. Nov-Dec;6(6):601-608 10.3201/eid0606.000608
4. Feldmann J, Le Deist F, Ouachee-Chardin M, et al. Functional consequences of perforin gene mutations in 22 patients with familial haemophagocytic lymphohistioc-ytosis. Br J Haematol. Jun 2002;117(4): 965-72.[Medline].
5. Ramachandran B, Balasubramanian S, Abhishek N, Ravikumar KG, Ramanan AV. Profile of hemophagocytic-lymphohistiocytosis in children in a tertiary care hospital in India. Indian Pediatr. 2011; 48:31-5.