Spontaneous recovery of haemophagocytic syndrome in an adolescent girl receiving anti-tuberculosis treatment
Enfeksiyon ilişkili hemofagositik sendrom (HPS) nadirdir ve potansiyel olarak ölümcül olabilir. Reaktif HPS, tüberküloz dâhil olmak üzere çeşitli enfeksiyonlarla birlikte bildirilmiştir. Tüberküloz ilişkili HPS erişkinlerde çocuklara göre daha sık görülür. Tüberküloz tedavisi ile birlikte HPS ilişkili şiddetli pansitopeni nadiren bildirilmiştir. Tedavi başarısı tedavinin erken başlamasına bağlıdır. Bu makalede anti-tüberküloz tedavisi sırasında ciddi pansitopeni gelişen 13 yaşında bir kız çocuğu sunulmaktadır. Kemik iliği aspirasyonunda trilineage dispoyez, debris fagosite etmiş histiyositler ve reaktif HPS’yi gösteren hemofagositoz vardı. Hasta destek tedavisi ile tamamen iyileşti
Spontaneous recovery of haemophagocytic syndrome in an adolescent girl receiving anti-tuberculosis treatment
Ramesh Bhat.Y, K Shruthi, MS Padma, SR Vamsi, G Sherin, K Annamma Infection associated haemophagocytic syndrome (HPS) is rare and could be potentially fatal. Reactive HPS has been reported with various infections including tuberculosis. Tuberculosis associated HPS is more common in adults than in children. Severe pancytopenia due to HPS complicating tuberculosis and while on therapy has been rarely described. Success of therapy depends on early initiation of treatment. We describe herein a 13-years old girl who developed severe pancytopenia while on anti-tuberculous treatment. Her bone marrow aspirate showed trilineage dyspoiesis, histiocytes with phagocytosed debris and haemophagocytosis confirming a reactive haemophagocytic syndrome. She recovered completely with supportive treatment.
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- Balkis MM, Bazzi L, Taher A, et al. Severe hemophagocytic syndrome developing after treatment initiation for dissemi- nated Mycobacterium tuberculosis: case report and literature review. Scand J Infect Dis 2009;41:535-537.
- Okascharoen C, Nuntnarumit P, Sirinavin S. Neonatal tubercu- losis associated with shock, disseminated intravascular co- agulation, hemophagocytic syndrome, and hypercalcemia: a case report. J Perinatol 2003;23:79-81.
- Balasubramanian S, Kaarthigeyan K, Aparna V, Srinivas S. Tuberculosis-associated hemophagocytic syndrome in in- fancy. Indian Pediatr 2008;45:593-595.
- Dilber E, Erduran E, Kalyoncu M, et al. Hemophagocytic syn- drome as an initial presentation of miliary tuberculosis with- out pulmonary findings. Scand J Infect Dis 2002;34:689-692.
- Fisman DN. Hemophagocytic syndromes and infection. Emerg Infect Dis 2000;6:601-608.
- Emmenegger U, Schaer DJ, Larroche C, Neftel KA. Haemo- phagocytic syndromes in adults: current concepts and chal- lenges ahead. Swiss Med Wkly 2005;135:299-314.