Hemophagocytic Lymphohistiocytosis Associated With Parvovirus B19 in a Patient With Acquired Immunodeficiency Syndrome

J Investig Med High Impact Case Rep. 2019 Jan-Dec:7:2324709619883698. doi: 10.1177/2324709619883698.

Abstract

Hemophagocytic lymphohistiocytosis (HLH) is a rare and life-threatening condition characterized by widespread inflammation due to massive immune activation and cytokine release. It is of 2 types, primary or familial and secondary or acquired. Diagnosis is made by fulfilling 5 of 8 criteria as determined by the Histiocyte Society. Treatment includes etoposide, dexamethasone, with or without intrathecal methotrexate in the presence of neurologic involvement as well as treating the underlying cause in secondary HLH. We present a case of a 23-year-old female with congenital human immunodeficiency virus (HIV) infection who presents with nonspecific signs and symptoms of cough, fever, leukopenia, and anemia, and a high-serum parvovirus B19 DNA, later diagnosed with HLH and treated with etoposide and dexamethasone. She made clinical improvements and was successfully discharged to home after 26 days of admission.

Keywords: HIV; hemophagocytic; lymphohistiocytosis; parvovirus.

Publication types

  • Case Reports

MeSH terms

  • AIDS-Related Opportunistic Infections / diagnosis*
  • Acquired Immunodeficiency Syndrome / congenital
  • Dexamethasone / administration & dosage
  • Dexamethasone / therapeutic use
  • Drug Therapy, Combination
  • Etoposide / administration & dosage
  • Etoposide / therapeutic use
  • Female
  • Humans
  • Lymphohistiocytosis, Hemophagocytic / diagnosis
  • Lymphohistiocytosis, Hemophagocytic / drug therapy
  • Lymphohistiocytosis, Hemophagocytic / etiology
  • Lymphohistiocytosis, Hemophagocytic / virology*
  • Parvoviridae Infections / complications*
  • Parvoviridae Infections / diagnosis
  • Parvoviridae Infections / etiology
  • Parvoviridae Infections / virology
  • Parvovirus B19, Human*
  • Young Adult

Substances

  • Etoposide
  • Dexamethasone