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A Case of Malaria-Associated Hemophagocytic Lymphohistiocytosis

Hemophagocytic lymphohistiocytosis (HLH) is an inflammatory syndrome of inappropriate and excessive immune system activation. It often occurs in the setting of viral, bacterial, fungal, and parasitic infections. HLH associated with malaria is very rare, and literature on this association is limited....

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Autores principales: Almajed, Mohamed Ramzi, Cerna-Viacava, Renato, Priessnitz, Jennifer, Khan, Naoshin, Zervos, Marcus
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9508862/
https://www.ncbi.nlm.nih.gov/pubmed/36171833
http://dx.doi.org/10.7759/cureus.28386
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author Almajed, Mohamed Ramzi
Cerna-Viacava, Renato
Priessnitz, Jennifer
Khan, Naoshin
Zervos, Marcus
author_facet Almajed, Mohamed Ramzi
Cerna-Viacava, Renato
Priessnitz, Jennifer
Khan, Naoshin
Zervos, Marcus
author_sort Almajed, Mohamed Ramzi
collection PubMed
description Hemophagocytic lymphohistiocytosis (HLH) is an inflammatory syndrome of inappropriate and excessive immune system activation. It often occurs in the setting of viral, bacterial, fungal, and parasitic infections. HLH associated with malaria is very rare, and literature on this association is limited. Significant overlap exists between these two conditions, which makes the diagnosis of HLH superimposed on malaria difficult. We present a case of a patient who recently traveled from Djibouti and was diagnosed with Plasmodium falciparum malaria. She had a transient improvement in response to antimalarial therapy followed by clinical deterioration. This prompted further investigations that revealed the diagnosis of HLH, which was confirmed by an elevated soluble interleukin-2 receptor CD25 (sCD25) level, a specific marker of HLH. Most patients recover with antimalarial therapy, supportive care, and monitoring, whereas some patients require immunosuppressive therapy. Maintaining a high index of suspicion for HLH-associated malaria in at-risk patients allows for early identification and management.
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spelling pubmed-95088622022-09-27 A Case of Malaria-Associated Hemophagocytic Lymphohistiocytosis Almajed, Mohamed Ramzi Cerna-Viacava, Renato Priessnitz, Jennifer Khan, Naoshin Zervos, Marcus Cureus Internal Medicine Hemophagocytic lymphohistiocytosis (HLH) is an inflammatory syndrome of inappropriate and excessive immune system activation. It often occurs in the setting of viral, bacterial, fungal, and parasitic infections. HLH associated with malaria is very rare, and literature on this association is limited. Significant overlap exists between these two conditions, which makes the diagnosis of HLH superimposed on malaria difficult. We present a case of a patient who recently traveled from Djibouti and was diagnosed with Plasmodium falciparum malaria. She had a transient improvement in response to antimalarial therapy followed by clinical deterioration. This prompted further investigations that revealed the diagnosis of HLH, which was confirmed by an elevated soluble interleukin-2 receptor CD25 (sCD25) level, a specific marker of HLH. Most patients recover with antimalarial therapy, supportive care, and monitoring, whereas some patients require immunosuppressive therapy. Maintaining a high index of suspicion for HLH-associated malaria in at-risk patients allows for early identification and management. Cureus 2022-08-25 /pmc/articles/PMC9508862/ /pubmed/36171833 http://dx.doi.org/10.7759/cureus.28386 Text en Copyright © 2022, Almajed et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Internal Medicine
Almajed, Mohamed Ramzi
Cerna-Viacava, Renato
Priessnitz, Jennifer
Khan, Naoshin
Zervos, Marcus
A Case of Malaria-Associated Hemophagocytic Lymphohistiocytosis
title A Case of Malaria-Associated Hemophagocytic Lymphohistiocytosis
title_full A Case of Malaria-Associated Hemophagocytic Lymphohistiocytosis
title_fullStr A Case of Malaria-Associated Hemophagocytic Lymphohistiocytosis
title_full_unstemmed A Case of Malaria-Associated Hemophagocytic Lymphohistiocytosis
title_short A Case of Malaria-Associated Hemophagocytic Lymphohistiocytosis
title_sort case of malaria-associated hemophagocytic lymphohistiocytosis
topic Internal Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9508862/
https://www.ncbi.nlm.nih.gov/pubmed/36171833
http://dx.doi.org/10.7759/cureus.28386
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