tetano
Editor, Senior Moderator
IntroductionHemophagocytic lymphohistiocytosis induced by viral diseases is a well recognized entity. Severe forms of H5N1 influenza are known to be associated with symptoms very similar to a reactive hemophagocytic syndrome.
We report a case of fulminant lymphohistiocytosis associated with the pandemic A (H1N1) variant.Case presentationA 42-year-old Caucasian woman developed a syndrome of fatal hemophagocytic lymphohistiocytosis shortly after H1N1 influenza. Initial symptoms of the viral disease were unusual, with acute abdominal involvement.
Our patient's course was complicated by diffuse skin rash and ileal ischemia. Our patient died of refractory shock and multi-organ failure.
Skin, ileum and colon histology was consistent with an acute apoptosis combined with an increased cellular regeneration.
Conclusions: Influenza may be complicated by severe forms of hemophagocytic lymphohistiocytosis. To ensure early recognition and treatment, physicians should be aware of the possible induction of the syndrome by the novel H1N1 variant.
The rapid occurrence of a multi-organ involvement with evocative biological features of macrophage activation should alert clinicians.
Author: Christophe WillekensAurelie CorneliusMary-Jane GuerryAgnes WacrenierFrancois Fourrier
Credits/Source: Journal of Medical Case Reports 2011, 5:280
http://7thspace.com/headlines/38814..._pandemic_a_h1n1_influenza_a_case_report.html
We report a case of fulminant lymphohistiocytosis associated with the pandemic A (H1N1) variant.Case presentationA 42-year-old Caucasian woman developed a syndrome of fatal hemophagocytic lymphohistiocytosis shortly after H1N1 influenza. Initial symptoms of the viral disease were unusual, with acute abdominal involvement.
Our patient's course was complicated by diffuse skin rash and ileal ischemia. Our patient died of refractory shock and multi-organ failure.
Skin, ileum and colon histology was consistent with an acute apoptosis combined with an increased cellular regeneration.
Conclusions: Influenza may be complicated by severe forms of hemophagocytic lymphohistiocytosis. To ensure early recognition and treatment, physicians should be aware of the possible induction of the syndrome by the novel H1N1 variant.
The rapid occurrence of a multi-organ involvement with evocative biological features of macrophage activation should alert clinicians.
Author: Christophe WillekensAurelie CorneliusMary-Jane GuerryAgnes WacrenierFrancois Fourrier
Credits/Source: Journal of Medical Case Reports 2011, 5:280
http://7thspace.com/headlines/38814..._pandemic_a_h1n1_influenza_a_case_report.html