Hemophagocytic Lymphohistiocytosis in A Child With Very Severe Aplastic Anemia: Double Jeopardy Resulting in Fatality.

Rumesh Chandar, Venkatesh Chandrasekaran, Barath Jagadisan, Delhi Kumar, Niranjan Biswal

Journal: Journal of pediatric hematology/oncology 2017;39(1):e43-e45

PMID: 27548335

Abstract

A 7-year-old male child with very severe aplastic anemia developed refractory disease, which was attributed to febrile hemolytic transfusion reactions and was treated with immunosuppressants, which lead to a transient improvement. However, the child worsened subsequently and succumbed to an underlying hemophagocytic lymphohistiocytosis that was recognized late due to an overlap of clinical and biochemical parameters in both the conditions. Hemophagocytic lymphohistiocytosis should be an early suspicion in children with refractory very severe aplastic anemia and the detection of underlying gene mutations can predict disease severity.

Address: Department of Pediatrics, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India.

DOI: 10.1097/MPH.0000000000000671

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MeSH Terms: Anemia, Aplastic, Antilymphocyte Serum, Blood Transfusion, Child, Danazol, Delayed Diagnosis, Diagnostic Errors, Disease Progression, Drug Resistance, Fatal Outcome, Febrile Neutropenia, Hepatomegaly, Humans, Immunosuppressive Agents, Iron Overload, Lymphohistiocytosis, Hemophagocytic, Male, Splenomegaly