Hemophagocytosis Associated with Hepatitis A and E Coinfection in a Young Child

Abstract

We report and discuss a unique case of hemophagocytosis associated with hepatitis A and E coinfection in a young child which has never been reported earlier in children. Its varied presentation is emphasized and possible management options and outcome are discussed.

Macrophage activation syndrome with acute hepatitis E during tocilizumab treatment for rheumatoid arthritis

“…We identified three reported cases of MAS triggered by hepatitis E. Two of the patients had hepatitis E alone, in 2013 and 2008, respectively [12,13], and the third had HEV-HAV co-infection [14].…”

Hepatitis A infection related haemophagocytic syndrome: a case report and systematic review

“…Full texts were available for 24 cases and only abstracts available for two cases in the articles reviewed. 3,4,6–26…”

“…Navamani et al 11 3.5 M India Oral dexamethasone þ cyclosporine Alive Navamani et al 11 9 F India IV dexamethasone þ cyclosporine Alive SJIA Canoz et al 12 10 M Turkey IVIg þ dexamethasone Alive Onaga et al 13 19 F Japan IV methylprednisolone Alive Bay et al 15 1 M Turkey IVIg Alive Bay et al 15 11 M Turkey IVIg Alive Das et al 16 4 M India Dexamethasone Alive Kondo et al 17 49 F Japan Methylprednisolone þ G-CSF Alive Lee et al 18 26 21 20 F England Hydrocortisone þ IVIg Alive SJIA Russo et al 22 3 F Argentina Dexamethasone þ etoposide Alive SJIA Tai et al 23 32 M Taipei Steroid, cyclosporine þ etanercept Alive Alhaddad et al 25 19 F Egypt IV methylprednisolone Alive Kaur et al 10 6 F India IV dexamethasone Died HEV co-infection Choudhary et al 14 5 F India Etoposide, dexamethasone þ cyclosporine Died HEV co-infection Ishii et al 19 37 M Japan Plasma exchange, methylprednisolone, cyclophosphamide þ vincristine Died Russo et al 22 3 F Argentina Methylprednisolone, cyclosporine þ etanercept Died SJIA Wu et al 24 23 M China Steroid Died HCV infection Park et al 26 28 F South Korea NA Died HCV, hepatitis C virus; HEV, hepatitis E virus; IVIg, intravenous immunoglobulin; SJIA, systemic juvenile idiopathic arthritis.…”

Extrahepatic manifestations of hepatitis E virus: An overview

“…Few cases of HEV-related hemophagocytic syndrome have been documented. [69][70][71] Also, HEV infection has been detected in patients with CD30 (+) cutaneous T cell lymphoproliferative disorder 72 and monoclonal gammopathy of undetermined significance (MGUS). However, the relation between MGUS and HEV remains uncertain.…”