Haemophagocytic histiocyte in a peripheral blood film

Sloma, Ivan; Vincent, H.; Addebbous, Amal; Rivoisy, Claire; Turhan, Ali G.; Michot, Jean‐Marie

doi:10.1111/bjh.12697

Cited by 6 publications

(3 citation statements)

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“…Cytological evidence of hemophagocytosis is usually found in bone marrow films or in biopsies of other organs such as lymph nodes, liver, spleen, and skin 5) . The observation of hemophagocytic macrophages in a peripheral blood smear is uncommon.…”

Section: Discussionmentioning

confidence: 99%

Peripheral platelet phagocytosis in an extremely low birth weight infant:a case report

Hatanaka

Ito

Fukama

et al. 2022

FJMS

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A 768 g female neonate, born at 25 weeks' gestation, developed sepsis due to methicillinresistant Staphylococcus epidermidis on day 14. Severe thrombocytopenia was observed, and hemophagocytic macrophages were identified in her peripheral blood smear. Cytokine profiles at the time of onset suggested that an inflammatory cytokine storm had activated lymphocytes and macrophages, leading to platelet phagocytosis. After administration of vancomycin for 14 days and immunoglobulin therapy, she improved without any complications. Considering the results of cytokine profiles, early intervention for infection may have prevented progression to hemophagocytic lymphohistiocytosis and reduced the severity of clinical symptoms.

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Section: Discussionmentioning

confidence: 99%

Peripheral platelet phagocytosis in an extremely low birth weight infant:a case report

Hatanaka

Ito

Fukama

et al. 2022

FJMS

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“…Morphological findings of hemophagocytic histiocytes are predominantly evident in bone marrow aspirate films or tissue biopsies, and they are seldom observed in peripheral blood films. However, when it does appear in peripheral blood smears, it is typically associated with a high risk of fatality [ 5 ]. We present a case involving a seven-year-old girl who had methicillin-resistant Staphylococcus aureus (MRSA) infective endocarditis and subsequently displayed characteristic hemophagocytic activity on her peripheral blood smear.…”

Section: Introductionmentioning

confidence: 99%

An Unusual Case of Phagocytic Histiocytes on Peripheral Blood Smear of a Patient With Methicillin-Resistant Staphylococcus aureus (MRSA) Endocarditis

Ali,

Sumbul,

Nadeem

2023

Cureus

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Hemophagocytic lymphohistiocytosis (HLH) is a rare disorder of the immune system that may rapidly progress into life-threatening complications. There is uncontrolled activation of histiocytes and phagocytic macrophages, resulting in excess secretions of cytokines that manifest into systemic hyperinflammation affecting several organs. HLH may present as primary due to underlying familial or genetic causes or as secondary due to underlying conditions such as malignancies, infections, or autoimmune disorders. This case is of a seven-year-old girl who developed culture-proven MRSA infective endocarditis. She received sensitivity-tailored antimicrobial treatment. Initially unremarkable, but later her peripheral blood smear showed the presence of large histiocyte-like cells showing hemophagocytic activity of moderate grade (two to five histiocytes with hemophagocytosis/slide) on the feathered edge of the slide. Peripheral film findings triggered further workup for HLH. Her condition later deteriorated, requiring high-dependency unit care. This case highlights the significance of maintaining a high index of suspicion with subsequent laboratory work in cases that develop cardinal diagnostic criteria for clinical manifestations of HLH. It also emphasizes reviewing the feathered edges of blood smears to prevent overlooking important morphological findings.

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“…They are often associated with hemophagocytic lymphohistiocytosis secondary to three groups of disorders: infections, neoplasia, or autoimmune diseases. Sloma et al [ 1 ] described the presence of a peripheral phagocytic histiocyte in a patient with acute myeloid leukemia following an episode of severe pneumonia and they suggested that it was probably related to an inappropriate host immune response to the pneumonia. Sayagh et al [ 2 ] hypothesized that, in addition to the autoimmune context, donor/recipient incompatibility was at play in low immunogenic red cell groups in the case of a 10-month-old baby transfused with packed RBCs.…”

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confidence: 99%