Secondary HLH Case Report Highlighting Clinical Challenges

A 19-year-old patient with relapsed acute myeloid leukemia (AML) developed severe and prolonged cytopenia and unexplained jaundice and fever after salvage chemotherapy. His workup revealed hemophagocytosis on the bone marrow biopsy. He was treated for HLH (hemophagocytic lymphohistiocytosis) seconda...

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Main Authors: Riad El Fakih, Said Y. Mohamed, Randa Alnounou, Ghada Elgohary
Format: Article
Language:English
Published: Wiley 2018-01-01
Series:Case Reports in Hematology
Online Access:http://dx.doi.org/10.1155/2018/1913938
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author Riad El Fakih
Said Y. Mohamed
Randa Alnounou
Ghada Elgohary
author_facet Riad El Fakih
Said Y. Mohamed
Randa Alnounou
Ghada Elgohary
author_sort Riad El Fakih
collection DOAJ
description A 19-year-old patient with relapsed acute myeloid leukemia (AML) developed severe and prolonged cytopenia and unexplained jaundice and fever after salvage chemotherapy. His workup revealed hemophagocytosis on the bone marrow biopsy. He was treated for HLH (hemophagocytic lymphohistiocytosis) secondary to AML and chemotherapy. The patient died on day 56 after starting his salvage chemotherapy. Unexpectedly, after his death, the microbiology laboratory reported positive mycobacterial growth from a bronchoalveolar lavage (BAL) sample taken during the workup of his fever. This case illustrates the difficulties in the diagnostic workup of HLH to identify triggers in a timely manner so that a targeted and specific therapy can be administered quickly, given the rapid and deadly evolution of the HLH process.
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publishDate 2018-01-01
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series Case Reports in Hematology
spelling doaj-art-eb2af842b3c046c2bcce454fe05edca22025-08-20T03:21:16ZengWileyCase Reports in Hematology2090-65602090-65792018-01-01201810.1155/2018/19139381913938Secondary HLH Case Report Highlighting Clinical ChallengesRiad El Fakih0Said Y. Mohamed1Randa Alnounou2Ghada Elgohary3King Faisal Specialist Hospital and Research Center, P.O. Box 3354, Riyadh 11211, Saudi ArabiaKing Faisal Specialist Hospital and Research Center, P.O. Box 3354, Riyadh 11211, Saudi ArabiaKing Faisal Specialist Hospital and Research Center, P.O. Box 3354, Riyadh 11211, Saudi ArabiaKing Faisal Specialist Hospital and Research Center, P.O. Box 3354, Riyadh 11211, Saudi ArabiaA 19-year-old patient with relapsed acute myeloid leukemia (AML) developed severe and prolonged cytopenia and unexplained jaundice and fever after salvage chemotherapy. His workup revealed hemophagocytosis on the bone marrow biopsy. He was treated for HLH (hemophagocytic lymphohistiocytosis) secondary to AML and chemotherapy. The patient died on day 56 after starting his salvage chemotherapy. Unexpectedly, after his death, the microbiology laboratory reported positive mycobacterial growth from a bronchoalveolar lavage (BAL) sample taken during the workup of his fever. This case illustrates the difficulties in the diagnostic workup of HLH to identify triggers in a timely manner so that a targeted and specific therapy can be administered quickly, given the rapid and deadly evolution of the HLH process.http://dx.doi.org/10.1155/2018/1913938
spellingShingle Riad El Fakih
Said Y. Mohamed
Randa Alnounou
Ghada Elgohary
Secondary HLH Case Report Highlighting Clinical Challenges
Case Reports in Hematology
title Secondary HLH Case Report Highlighting Clinical Challenges
title_full Secondary HLH Case Report Highlighting Clinical Challenges
title_fullStr Secondary HLH Case Report Highlighting Clinical Challenges
title_full_unstemmed Secondary HLH Case Report Highlighting Clinical Challenges
title_short Secondary HLH Case Report Highlighting Clinical Challenges
title_sort secondary hlh case report highlighting clinical challenges
url http://dx.doi.org/10.1155/2018/1913938
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AT saidymohamed secondaryhlhcasereporthighlightingclinicalchallenges
AT randaalnounou secondaryhlhcasereporthighlightingclinicalchallenges
AT ghadaelgohary secondaryhlhcasereporthighlightingclinicalchallenges