Infectious Mimicry Complicates Diagnosis in Hemophagocytic Syndrome Caused by Anaplastic Large-Cell Lymphoma

Hemophagocytic syndrome (HPS) arises secondary to genetic, rheumatologic, neoplastic, and infectious causes. We discuss a patient whose presentation was consistent with systemic infection but was discovered to have HPS of unknown etiology. The presenting symptoms, as well as unremarkable malignancy...

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Main Authors: Michael J. Peluso, David Chia, Whitney Sheen, Christoph Hutchinson, Lydia Barakat
Format: Article
Language:English
Published: Wiley 2012-01-01
Series:Case Reports in Medicine
Online Access:http://dx.doi.org/10.1155/2012/968706
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author Michael J. Peluso
David Chia
Whitney Sheen
Christoph Hutchinson
Lydia Barakat
author_facet Michael J. Peluso
David Chia
Whitney Sheen
Christoph Hutchinson
Lydia Barakat
author_sort Michael J. Peluso
collection DOAJ
description Hemophagocytic syndrome (HPS) arises secondary to genetic, rheumatologic, neoplastic, and infectious causes. We discuss a patient whose presentation was consistent with systemic infection but was discovered to have HPS of unknown etiology. The presenting symptoms, as well as unremarkable malignancy and rheumatologic workups, led to the pursuit of an infectious cause, but the patient was ultimately discovered to have an occult anaplastic large-cell lymphoma (ALCL). This case demonstrates the diagnostic challenges that result from infectious mimicry in the context of HPS—first, in distinguishing noninfectious HPS from the systemic inflammation that can result from a widespread infectious process, second, in the identification of the precipitating cause of HPS. While evidence of these challenges has been suggested by the limited literature on HPS and ALCL, our case illustrates the diagnostic dilemma that arises when tissue biopsy does not quickly reveal an etiology. It is important that all physicians be aware that HPS can mimic infection and be prepared to redirect the workup when an infectious etiology for HPS cannot be identified.
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spelling doaj-art-0eee6d7eafdb4933ab90e8f1e84632cd2025-08-20T03:54:30ZengWileyCase Reports in Medicine1687-96271687-96352012-01-01201210.1155/2012/968706968706Infectious Mimicry Complicates Diagnosis in Hemophagocytic Syndrome Caused by Anaplastic Large-Cell LymphomaMichael J. Peluso0David Chia1Whitney Sheen2Christoph Hutchinson3Lydia Barakat4School of Medicine, Yale University, New Haven, CT 06510, USAPrimary Care Center and Department of Internal Medicine, School of Medicine, Yale University, New Haven, CT 06510, USASchool of Medicine, Yale University, New Haven, CT 06510, USADepartment of Internal Medicine, School of Medicine, Yale University, New Haven, CT 06510, USASection of Infectious Diseases, School of Medicine, Yale University, New Haven, CT 06510, USAHemophagocytic syndrome (HPS) arises secondary to genetic, rheumatologic, neoplastic, and infectious causes. We discuss a patient whose presentation was consistent with systemic infection but was discovered to have HPS of unknown etiology. The presenting symptoms, as well as unremarkable malignancy and rheumatologic workups, led to the pursuit of an infectious cause, but the patient was ultimately discovered to have an occult anaplastic large-cell lymphoma (ALCL). This case demonstrates the diagnostic challenges that result from infectious mimicry in the context of HPS—first, in distinguishing noninfectious HPS from the systemic inflammation that can result from a widespread infectious process, second, in the identification of the precipitating cause of HPS. While evidence of these challenges has been suggested by the limited literature on HPS and ALCL, our case illustrates the diagnostic dilemma that arises when tissue biopsy does not quickly reveal an etiology. It is important that all physicians be aware that HPS can mimic infection and be prepared to redirect the workup when an infectious etiology for HPS cannot be identified.http://dx.doi.org/10.1155/2012/968706
spellingShingle Michael J. Peluso
David Chia
Whitney Sheen
Christoph Hutchinson
Lydia Barakat
Infectious Mimicry Complicates Diagnosis in Hemophagocytic Syndrome Caused by Anaplastic Large-Cell Lymphoma
Case Reports in Medicine
title Infectious Mimicry Complicates Diagnosis in Hemophagocytic Syndrome Caused by Anaplastic Large-Cell Lymphoma
title_full Infectious Mimicry Complicates Diagnosis in Hemophagocytic Syndrome Caused by Anaplastic Large-Cell Lymphoma
title_fullStr Infectious Mimicry Complicates Diagnosis in Hemophagocytic Syndrome Caused by Anaplastic Large-Cell Lymphoma
title_full_unstemmed Infectious Mimicry Complicates Diagnosis in Hemophagocytic Syndrome Caused by Anaplastic Large-Cell Lymphoma
title_short Infectious Mimicry Complicates Diagnosis in Hemophagocytic Syndrome Caused by Anaplastic Large-Cell Lymphoma
title_sort infectious mimicry complicates diagnosis in hemophagocytic syndrome caused by anaplastic large cell lymphoma
url http://dx.doi.org/10.1155/2012/968706
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