Miliary tuberculosis with splenic rupture: A fatal case with hemophagocytic syndrome and possible association with long standing sarcoidosis

Lam, Alfred King‐Yin; Ng, William; Chan, Alexander C.L.

doi:10.1080/00313029400169262

Cited by 19 publications

(10 citation statements)

References 24 publications

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“…As far as we know, only 13 cases with reactive haemophagocytic his tiocytosis and tuberculosis have been reported previously [4][5][6][7][8][9][10][11][12][13][14] (table 1).…”

Section: Discussionmentioning

confidence: 99%

“…Common presenting fea tures of this uncommon syndrome include fever, malaise, weight loss, hepatosplenomegaly, lymphadenopathy, and profound cytopenia involving two or more cell lines [2], The clinical course is generally fulminant and may be complicated by coagulation abnormalities, hepatic dys function and renal failure [2], Other conditions have also been recognized to be associated with reactive HS, includ ing infections with different bacteria, fungi, parasites, Rickettsia spp., as well as haematologic malignancies and carcinomas [2,3], We present here two cases of tuberculosis-associated HS. To the best of our knowledge, only 13 cases of such an association have previously been reported [4][5][6][7][8][9][10][11][12][13][14], Both our cases recovered with antituberculosis therapy, in ad dition to intensive supportive measures in case 1 whose clinical presentation was extremely severe. He showed a very favourable clinical course following treatment with high-dose méthylprednisolone (HDMP) and intravenous immunoglobulin (IVIG).…”

Section: Introductionmentioning

confidence: 93%

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Tuberculosis-Associated Haemophagocytic Syndrome: A Report of Two Cases and a Review of the Literature

Ündar¹,

Karpuzoğlu²,

Karadogan³

et al. 1996

Acta Haematol

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The haemophagocytic syndrome (HS) is an uncommon reactive proliferation of mature histiocytes, and is more frequently but not exclusively associated with infections in individuals with pre-existing immunologic abnormalities. As far as we know, only 13 cases of tuberculosis-associated HS have previously been reported. We present here two cases of disseminated tuberculosis-associated HS. Both of the cases recovered with antituberculosis therapy. High-dose methylprednisolone and intravenous immunoglobulin were added in one case because of the extremely severe clinical presentation. This therapy seemed to contribute to the favourable outcome of the patient. The similarities in HLA phenotypes of this patient and others reported in the literature may provide evidence for an underlying immune dysregulation in some cases of infection-associated HS.

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“…As far as we know, only 13 cases with reactive haemophagocytic his tiocytosis and tuberculosis have been reported previously [4][5][6][7][8][9][10][11][12][13][14] (table 1).…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 93%

Tuberculosis-Associated Haemophagocytic Syndrome: A Report of Two Cases and a Review of the Literature

Ündar¹,

Karpuzoğlu²,

Karadogan³

et al. 1996

Acta Haematol

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“…Pathological rupture of the spleen has been associated with a wide variety of underlying conditions, and the phenomenon is uncommon but frequently fatal [9]. While infectious diseases including infectious mononucleosis [5] and malaria [6] have been the most commonly reported disorders associated with splenic rupture, associations with sarcoidosis [10], connective tissue disorders [11, 12] and amyloidosis [13] have also been reported. However, hematological malignancies rarely cause splenic rupture, despite the frequent involvement of the spleen in these diseases [1,2,3,4].…”

Section: Discussionmentioning

confidence: 99%

Fatal Splenic Rupture Caused by Infiltration of Adult T Cell Leukemia Cells

Arimura

Arima²,

Kukita

et al. 2005

Acta Haematol

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The spleen is an immunological organ commonly involved in both hematological and nonhematological diseases. Pathological rupture of the spleen has been described in a variety of diseases affecting the spleen. Infections have been cited in most cases involving splenic rupture, but are rare in hematological malignancies despite frequent involvement of the spleen. The present report describes a fatal case of splenic rupture caused by infiltration of adult T cell leukemia cells and reports the mechanism of splenic rupture. The importance of rapid diagnosis and surgery is emphasized.

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“…(19) The authors of another study reported a case of miliary tuberculosis complicated by HPS in a patient who had been diagnosed with sarcoidosis. (20) In those two cases (sarcoidosis and HPS), the patients died, having presented with fever, thrombocytopenia, and elevated triglyceride levels.…”

Section: Discussionmentioning

confidence: 99%

Síndrome hemofagocítica devido a sarcoidose pulmonar

et al. 2012

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Although hemophagocytic syndrome is a rare clinical condition, it is associated with high mortality and the number of cases described in the literature has progressively increased. The diagnosis of hemophagocytic syndrome is made on the basis of a finding of hemophagocytosis. Sarcoidosis is a highly prevalent disease whose course and prognosis might correlate with the initial clinical presentation and the extent of the disease. We report the case of a patient with long-standing sarcoidosis who presented with intermittent fever and fatigue. The diagnosis of hemophagocytic syndrome was made by bone marrow aspiration, and specific treatment was ineffective. This is the third case of sarcoidosis-related hemophagocytic syndrome reported in the literature and the first reported in Latin America. All three cases had unfavorable outcomes.Keywords: Lymphohistiocytosis, hemophagocytic; Ferritins; Sarcoidosis, pulmonary; Macrophage activation syndrome. ResumoEmbora seja uma condição clínica rara, a síndrome hemofagocítica é associada com alta mortalidade e o número de casos descritos na literatura vem aumentando progressivamente. O diagnóstico de síndrome hemofagocítica depende da presença de hemofagocitose. A sarcoidose é uma doença de alta prevalência cujo curso e prognóstico podem correlacionar-se com a apresentação clínica inicial e a extensão da doença. Relatamos o caso de um paciente com sarcoidose de longa duração que apresentava febre intermitente e fadiga. O diagnóstico de síndrome hemofagocítica foi realizado por aspirado de medula óssea, e o tratamento específico foi ineficaz. Trata-se do terceiro caso de síndrome hemofagocítica relacionada a sarcoidose na literatura mundial e o primeiro na literatura latino-americana. Os três casos tiveram desfecho desfavorável. blood workup revealed leukocytosis (neutrophils, 32%). Anemia and thrombocytopenia were found. Electrolytes, creatinine, and urea were normal, and blood and urine cultures were negative (Table 1). The patient was hospitalized for further investigation. He had a medical history of diabetes and dyslipidemia but reported no allergies, blood transfusions, smoking, or alcohol consumption. DescritoresAt admission, the patient was febrile (39°C) and a little anxious. He had no jaundice, rash, or lymphadenopathy. His blood pressure was 130/70 mmHg, his RR was 21 breaths/min, his SaO 2 was 96%, and his HR was 88 bpm. Cardiovascular examination was normal. Pulmonary examination revealed normal breath sounds. Physical examination was otherwise unremarkable. Laboratory test results at admission were similar doses of prednisone (10 mg/day) in order to control the activity of the disease. The patient had been well until March of 2010, when he had episodes of fever. He received emergency room treatment, the amoxicillin-clavulanate combination having been prescribed. The fever did not subside. Ten days later, the patient sought emergency room treatment again (in the same emergency room) and received levofloxacin. The fever persisted, followed by mild dyspnea, a...

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Miliary tuberculosis with splenic rupture: A fatal case with hemophagocytic syndrome and possible association with long standing sarcoidosis

Cited by 19 publications

References 24 publications

Tuberculosis-Associated Haemophagocytic Syndrome: A Report of Two Cases and a Review of the Literature

Tuberculosis-Associated Haemophagocytic Syndrome: A Report of Two Cases and a Review of the Literature

Fatal Splenic Rupture Caused by Infiltration of Adult T Cell Leukemia Cells

Síndrome hemofagocítica devido a sarcoidose pulmonar

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