Successful Modified Therapy in a Patient with Probable Infection-Associated Hemophagocytic Lymphohistiocytosis.
Journal
Case reports in oncological medicine
ISSN: 2090-6706
Titre abrégé: Case Rep Oncol Med
Pays: United States
ID NLM: 101581035
Informations de publication
Date de publication:
2019
2019
Historique:
received:
23
01
2019
revised:
02
07
2019
accepted:
27
08
2019
entrez:
5
10
2019
pubmed:
5
10
2019
medline:
5
10
2019
Statut:
epublish
Résumé
Hemophagocytic lymphohistiocytosis (HLH) is a rare, hyperinflammatory syndrome characterized by clinical signs and symptoms of extreme inflammation. In adults, HLH is typically a complication of infections, autoimmune diseases, and malignancies. While the disease is often fatal, classic management of HLH revolves around early diagnosis and initiation of protocolized therapy. We present a case of a previously healthy 56-year-old female who developed distributive shock requiring intubation, vasopressors, and continuous venovenous hemofiltration. In the setting of multiple infectious syndromes, severe cytopenias, and rising direct hyperbilirubinemia, her diagnosis of HLH was confirmed. Therapy was initiated with dexamethasone and two doses of reduced-intensity etoposide based on the patient's clinical course. Over the next few weeks, she continued to improve on dexamethasone monotherapy and has maintained remission up to the present with complete resolution of her cytopenias and return of baseline renal function. Our case highlights the variability in the management of probable infection-associated HLH (IHLH) with a good patient outcome. We demonstrate the potential to treat IHLH with partial protocols and minimal chemotherapeutics.
Identifiants
pubmed: 31583147
doi: 10.1155/2019/9781065
pmc: PMC6754915
doi:
Types de publication
Case Reports
Langues
eng
Pagination
9781065Informations de copyright
Copyright © 2019 Carl L. Kay et al.
Déclaration de conflit d'intérêts
The authors declare that they have no conflicts of interest.
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