Hemophagocytic lymphohistiocytosis associated with acute otitis media: A case report
Hemophagocytic lymphohistiocytosis (HLH) is a potentially life-threatening syndrome for which early recognition and treatment are essential for improving outcomes. HLH is characterized by uncontrolled immune activation leading to fever, cytopenias, hepatosplenomegaly, coagulation abnormalities, and...
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Published in | Medicine (Baltimore) Vol. 103; no. 25; p. e38616 |
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Main Authors | , , , |
Format | Journal Article |
Language | English |
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Lippincott Williams & Wilkins
21.06.2024
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Abstract | Hemophagocytic lymphohistiocytosis (HLH) is a potentially life-threatening syndrome for which early recognition and treatment are essential for improving outcomes. HLH is characterized by uncontrolled immune activation leading to fever, cytopenias, hepatosplenomegaly, coagulation abnormalities, and elevated typical markers. This condition can be genetic or secondary, with the latter often triggered by infections. Here, we present a unique case of HLH secondary to acute otitis media (AOM), a common ear infection.
We describe a 4-year-old boy who initially presented with a high fever and otalgia, later diagnosed with bilateral AOM. Despite antibiotic treatment, his condition deteriorated.
The patient fulfilled diagnostic criteria for HLH.
Aggressive treatment by using combination therapy with immunoglobulins, intravenous steroids (dexamethasone), cyclosporine, and etoposide was performed.
After 1 month of treatment, improvement in the otologic symptoms was observed, and hematological findings gradually improved and normalized.
The link between AOM and HLH may be associated with inflammatory responses and immunological mechanisms, highlighting the importance of considering HLH in severe infection cases. This case emphasizes the need for prompt diagnosis and management, especially in secondary HLH scenarios, to improve patient outcomes. It is imperative to be aware of the potential correlation between these 2 conditions, and healthcare professionals should consider the likelihood of HLH. |
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AbstractList | Hemophagocytic lymphohistiocytosis (HLH) is a potentially life-threatening syndrome for which early recognition and treatment are essential for improving outcomes. HLH is characterized by uncontrolled immune activation leading to fever, cytopenias, hepatosplenomegaly, coagulation abnormalities, and elevated typical markers. This condition can be genetic or secondary, with the latter often triggered by infections. Here, we present a unique case of HLH secondary to acute otitis media (AOM), a common ear infection.
We describe a 4-year-old boy who initially presented with a high fever and otalgia, later diagnosed with bilateral AOM. Despite antibiotic treatment, his condition deteriorated.
The patient fulfilled diagnostic criteria for HLH.
Aggressive treatment by using combination therapy with immunoglobulins, intravenous steroids (dexamethasone), cyclosporine, and etoposide was performed.
After 1 month of treatment, improvement in the otologic symptoms was observed, and hematological findings gradually improved and normalized.
The link between AOM and HLH may be associated with inflammatory responses and immunological mechanisms, highlighting the importance of considering HLH in severe infection cases. This case emphasizes the need for prompt diagnosis and management, especially in secondary HLH scenarios, to improve patient outcomes. It is imperative to be aware of the potential correlation between these 2 conditions, and healthcare professionals should consider the likelihood of HLH. Hemophagocytic lymphohistiocytosis (HLH) is a potentially life-threatening syndrome for which early recognition and treatment are essential for improving outcomes. HLH is characterized by uncontrolled immune activation leading to fever, cytopenias, hepatosplenomegaly, coagulation abnormalities, and elevated typical markers. This condition can be genetic or secondary, with the latter often triggered by infections. Here, we present a unique case of HLH secondary to acute otitis media (AOM), a common ear infection.INTRODUCTIONHemophagocytic lymphohistiocytosis (HLH) is a potentially life-threatening syndrome for which early recognition and treatment are essential for improving outcomes. HLH is characterized by uncontrolled immune activation leading to fever, cytopenias, hepatosplenomegaly, coagulation abnormalities, and elevated typical markers. This condition can be genetic or secondary, with the latter often triggered by infections. Here, we present a unique case of HLH secondary to acute otitis media (AOM), a common ear infection.We describe a 4-year-old boy who initially presented with a high fever and otalgia, later diagnosed with bilateral AOM. Despite antibiotic treatment, his condition deteriorated.PATIENT CONCERNSWe describe a 4-year-old boy who initially presented with a high fever and otalgia, later diagnosed with bilateral AOM. Despite antibiotic treatment, his condition deteriorated.The patient fulfilled diagnostic criteria for HLH.DIAGNOSISThe patient fulfilled diagnostic criteria for HLH.Aggressive treatment by using combination therapy with immunoglobulins, intravenous steroids (dexamethasone), cyclosporine, and etoposide was performed.INTERVENTIONSAggressive treatment by using combination therapy with immunoglobulins, intravenous steroids (dexamethasone), cyclosporine, and etoposide was performed.After 1 month of treatment, improvement in the otologic symptoms was observed, and hematological findings gradually improved and normalized.OUTCOMESAfter 1 month of treatment, improvement in the otologic symptoms was observed, and hematological findings gradually improved and normalized.The link between AOM and HLH may be associated with inflammatory responses and immunological mechanisms, highlighting the importance of considering HLH in severe infection cases. This case emphasizes the need for prompt diagnosis and management, especially in secondary HLH scenarios, to improve patient outcomes. It is imperative to be aware of the potential correlation between these 2 conditions, and healthcare professionals should consider the likelihood of HLH.LESSIONSThe link between AOM and HLH may be associated with inflammatory responses and immunological mechanisms, highlighting the importance of considering HLH in severe infection cases. This case emphasizes the need for prompt diagnosis and management, especially in secondary HLH scenarios, to improve patient outcomes. It is imperative to be aware of the potential correlation between these 2 conditions, and healthcare professionals should consider the likelihood of HLH. |
Author | Lee, Kyu-Yup Jung, Da Jung Chung, Da Hyun Kim, Ji-Yoon |
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References | West (R6-20240803) 2022; 291 Niece (R5-20240803) 2010; 54 Koumadoraki (R11-20240803) 2022; 14 Henter (R9-20240803) 2007; 48 Parekh (R3-20240803) 2011; 56 Coburn (R15-20240803) 2021; 66 Berman (R8-20240803) 1995; 332 Canna (R2-20240803) 2020; 135 Ramos-Casals (R4-20240803) 2014; 383 Jordan (R13-20240803) 2024; 322 Ishii (R10-20240803) 2016; 4 Morris (R7-20240803) 2009; 56 Brisse (R12-20240803) 2017; 8 Schnaubelt (R14-20240803) 2021; 100 |
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SubjectTerms | Acute Disease Child, Preschool Clinical Case Report Cyclosporine - administration & dosage Cyclosporine - therapeutic use Dexamethasone - administration & dosage Dexamethasone - therapeutic use Etoposide - administration & dosage Etoposide - therapeutic use Humans Immunoglobulins, Intravenous - therapeutic use Lymphohistiocytosis, Hemophagocytic - complications Lymphohistiocytosis, Hemophagocytic - diagnosis Lymphohistiocytosis, Hemophagocytic - drug therapy Lymphohistiocytosis, Hemophagocytic - etiology Male Otitis Media - complications Otitis Media - drug therapy |
Title | Hemophagocytic lymphohistiocytosis associated with acute otitis media: A case report |
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