Epstein barr virus hemophagocytic lymphohistiocytosis related to rituximab use and immunopathogenetic insights

Papageorgiou, Sotirios G.; Tsiodras, Sotirios; Siakallis, Georgios; Bazani, Efthymia; Spathis, Aris; Poulakou, Garyphalia; Korkolopoulou, Penelope; Panayiotides, Ioannis G.; Pappa, Vasiliki

doi:10.1016/j.prp.2016.10.003

Cited by 7 publications

(3 citation statements)

References 16 publications

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“…However, rituximab was found occasionally to induce HLH during chemotherapy of lymphoproliferative disorders and evoked a flare-up of a hemophagocytic syndrome in a patient with systemic lupus erythematosus (SLE). 10 The case described herein suggests that HLH should be considered in the differential diagnosis in MS patients displaying a fever and malaise syndrome following administration of ocrelizumab.…”

Section: Discussionmentioning

confidence: 82%

Hemophagocytic lymphohistiocytosis associated with ocrelizumab treatment in a patient with multiple sclerosis

Machlańska¹,

Helbig

Chromik

et al. 2021

Mult Scler

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Background: Hemophagocytic lymphohistiocytosis (HLH) is a rarely recognized hyperinflammatory condition of high death risk. Objective: The objective was to describe a case of HLH in a patient with multiple sclerosis (MS) treated with ocrelizumab Methods: Clinical observation, laboratory testing, and use of HLH-2004 criteria for HLH diagnosis. Results: A 32-year-old Caucasian female developed HLH during ocrelizumab treatment. She met six of the eight HLH criteria including fever, splenomegaly, cytopenia, hypertriglyceridemia and hypofibrinogenemia, high serum ferritin level, and low natural killer (NK) cells. Conclusion: HLH should be considered in the differential diagnosis in MS patients displaying a fever and malaise syndrome following administration of ocrelizumab.

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Section: Discussionmentioning

confidence: 82%

Hemophagocytic lymphohistiocytosis associated with ocrelizumab treatment in a patient with multiple sclerosis

Machlańska¹,

Helbig

Chromik

et al. 2021

Mult Scler

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“…However, the association between HLH and B-cell leukemia has been rarely associated ( Table 1). It is important to note that in the majority of these cases, an infectious trigger was detected [10][11][12]14,17,18,[20][21][22]. It can be therefore postulated that in the setting of a dysfunctional immune system secondary to malignancy, infections are more likely to become overwhelming and act as a trigger for HLH.…”

Section: Discussionmentioning

confidence: 99%

A rare presentation of hemophagocytic lymphohistiocytosis in a patient with untreated chronic lymphocytic leukemia: A case report and review of the literature

Nwosu-Iheme¹,

Ghanem²,

Patel³

et al. 2018

Hematol Leuk

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Hemophagocytic Lymphohistiocytosis (HLH) is a state of exaggerated immune response that manifests with multiorgan failure and decreased peripheral counts. Primary HLH is secondary to a genetic defect that leads to a dysregulated immune response and usually manifests in infancy. Secondary HLH is more common in adults and is usually associated with an underlying trigger such as infections (such as Ebstein Bar Virus) or malignancy. HLH has been described with T-cell associated malignancies whereas its association with B-cell malignancies and chronic lymphocytic leukemia (CLL) is rare. We hereby present the case of a patient who presented with HLH secondary to untreated CLL and where no infectious cause was identified. We then review the literature and discuss the diagnosis, prognosis and treatment of HLH most likely triggered by progression of an underlying CLL.

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“…respectively. 9,10 There are only two cases describing HLH arising out of CLL without another trigger. 11,12 In our own HLH series, 13 there were only two other cases of CLL-associated HLH, one occurring after bone marrow transplantation, and another in the setting of transformation.…”

mentioning

confidence: 99%

Ibrutinib‐associated hemophagocytic lymphohistiocytosis: A case series from Johns Hopkins

et al. 2019

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Epstein barr virus hemophagocytic lymphohistiocytosis related to rituximab use and immunopathogenetic insights

Cited by 7 publications

References 16 publications

Hemophagocytic lymphohistiocytosis associated with ocrelizumab treatment in a patient with multiple sclerosis

Hemophagocytic lymphohistiocytosis associated with ocrelizumab treatment in a patient with multiple sclerosis

A rare presentation of hemophagocytic lymphohistiocytosis in a patient with untreated chronic lymphocytic leukemia: A case report and review of the literature

Ibrutinib‐associated hemophagocytic lymphohistiocytosis: A case series from Johns Hopkins

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