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Fatal Hemophagocytic Lymphohistiocytosis in a Patient with Miliary Tuberculosis: a Case Report
Hemophagocytic lymphohistiocytosis (HLH) is a life-threatening hyperinflammatory syndrome induced by cytotoxic T-cells. Mostly, HLH is secondary to infections, malignancies, or autoimmune disorders. HLH triggered by miliary tuberculosis is rare and mortality rates are high. We report a case of a 58-...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer International Publishing
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9281255/ https://www.ncbi.nlm.nih.gov/pubmed/35856014 http://dx.doi.org/10.1007/s42399-022-01232-y |
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author | Schippers, Eva E. Creemers, Sara G. Paltansing, Sunita van Zaanen, Henk C. T. Heijneman, Joyce A. M. |
author_facet | Schippers, Eva E. Creemers, Sara G. Paltansing, Sunita van Zaanen, Henk C. T. Heijneman, Joyce A. M. |
author_sort | Schippers, Eva E. |
collection | PubMed |
description | Hemophagocytic lymphohistiocytosis (HLH) is a life-threatening hyperinflammatory syndrome induced by cytotoxic T-cells. Mostly, HLH is secondary to infections, malignancies, or autoimmune disorders. HLH triggered by miliary tuberculosis is rare and mortality rates are high. We report a case of a 58-year-old, Caucasian patient admitted to the ICU with respiratory failure. After extensive tests, the diagnosis of HLH was made. Despite aggressive treatment with antibiotics, etoposide, anakinra, and tocilizumab, our patient succumbed to the illness after 18 days in the ICU. Postmortem, a diagnosis of miliary tuberculosis was made, despite negative PCR and culture of mycobacteria during clinical course. Our case demonstrates the challenges of early diagnosis of HLH and the importance of considering miliary tuberculosis as a possible underlying trigger. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s42399-022-01232-y. |
format | Online Article Text |
id | pubmed-9281255 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Springer International Publishing |
record_format | MEDLINE/PubMed |
spelling | pubmed-92812552022-07-14 Fatal Hemophagocytic Lymphohistiocytosis in a Patient with Miliary Tuberculosis: a Case Report Schippers, Eva E. Creemers, Sara G. Paltansing, Sunita van Zaanen, Henk C. T. Heijneman, Joyce A. M. SN Compr Clin Med Case Report Hemophagocytic lymphohistiocytosis (HLH) is a life-threatening hyperinflammatory syndrome induced by cytotoxic T-cells. Mostly, HLH is secondary to infections, malignancies, or autoimmune disorders. HLH triggered by miliary tuberculosis is rare and mortality rates are high. We report a case of a 58-year-old, Caucasian patient admitted to the ICU with respiratory failure. After extensive tests, the diagnosis of HLH was made. Despite aggressive treatment with antibiotics, etoposide, anakinra, and tocilizumab, our patient succumbed to the illness after 18 days in the ICU. Postmortem, a diagnosis of miliary tuberculosis was made, despite negative PCR and culture of mycobacteria during clinical course. Our case demonstrates the challenges of early diagnosis of HLH and the importance of considering miliary tuberculosis as a possible underlying trigger. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s42399-022-01232-y. Springer International Publishing 2022-07-14 2022 /pmc/articles/PMC9281255/ /pubmed/35856014 http://dx.doi.org/10.1007/s42399-022-01232-y Text en © The Author(s), under exclusive licence to Springer Nature Switzerland AG 2022 This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic. |
spellingShingle | Case Report Schippers, Eva E. Creemers, Sara G. Paltansing, Sunita van Zaanen, Henk C. T. Heijneman, Joyce A. M. Fatal Hemophagocytic Lymphohistiocytosis in a Patient with Miliary Tuberculosis: a Case Report |
title | Fatal Hemophagocytic Lymphohistiocytosis in a Patient with Miliary Tuberculosis: a Case Report |
title_full | Fatal Hemophagocytic Lymphohistiocytosis in a Patient with Miliary Tuberculosis: a Case Report |
title_fullStr | Fatal Hemophagocytic Lymphohistiocytosis in a Patient with Miliary Tuberculosis: a Case Report |
title_full_unstemmed | Fatal Hemophagocytic Lymphohistiocytosis in a Patient with Miliary Tuberculosis: a Case Report |
title_short | Fatal Hemophagocytic Lymphohistiocytosis in a Patient with Miliary Tuberculosis: a Case Report |
title_sort | fatal hemophagocytic lymphohistiocytosis in a patient with miliary tuberculosis: a case report |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9281255/ https://www.ncbi.nlm.nih.gov/pubmed/35856014 http://dx.doi.org/10.1007/s42399-022-01232-y |
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