H. GÜLEN, Ş. ASLAN, A. ŞİMŞEK, S. AYHAN, N. MOUMİN, E. KASIRGA

A case of hemophagocytic syndrome that presented as fulminant hepatic failure

Hemofagositik lenfohistiyositoz, ateş, parısitopeni, hepatosplenomegali ve kemik iliği, karaciğer ya da lenf nodları gibi doku ve organlarda hemofagositozla karakterize nadir görülen bir klinik tablodur. Ağır karaciğer yetmezliği ise önceden bilinen karaciğer hastalığı olmayan kişilerde hepatositlerin masif nekrozu ya da ağır fonksiyon kaybına bağlı gelişen klinik bir hastalık tablosudur. Hemofagositik lenfohistiyositozda karaciğer tutulumuna ait bulgular yaygın olarak görülmekte ve hastalığın seyrinde karaciğer yetmezliği tablosu da olabilmektedir. Ancak hastalığın ağır karaciğer yetmezliği tablosuyla başlaması çok iyi tanım/anmamıştır. Burada ağır karaciğer yetmezliği tablosuyla başvuran 9 yaşında bir kız olgu sunulmakta ve çocuklarda ağır karaciğer yetmezliğinin ayırıcı tanısında hemofagositik lenfohistiyositozun da düşünülmesi gerektiği vurgulanmaktadır.

Fulminan hepatik yetmezlikle başvuran hemofagositik sendromlu bir olgu

Hemophagocytic lymphohistiocytosis (HLH) is an uncommon clinical entity characterized by fever, pancytopenia, hepatosplenomegaly and hemophagocytosis in bone marrow, liver or lymph nodes. Fulminant hepatic failure (FHF) is a clinical syndrome resulting from massive necrosis of hepatocytes or severe functional impairment of hepatocytes in a patient who does not have a pre-existing liver disease. Hepatic manifestations are common in hemophagocytic lymphohistiocytosis and overt hepatic failure may occur, but initial presentation as fulminant hepatic failure is not well recognized. We report the case of a 9 year old girl presented with fulminant hepatic failure and "Hemophagocytic lymphohistiocytosis" should be considered in the differential diagnosis of fulminant hepatic failure in children.

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