Secondary haemophagocytic lymphohistiocytosis in an immuno-competent patient of extrapulmonary tuberculosis

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International Journal of Development Research

Volume: 
08
Article ID: 
11834
3 pages
Research Article

Secondary haemophagocytic lymphohistiocytosis in an immuno-competent patient of extrapulmonary tuberculosis

Dr. Ananda Mohan Chakraborty, Dr. Soumitra Ghosh, Dr. Srabani Ghosh, Dr. Abhishek Chowdhury and Dr. Debashish Mandal

Abstract: 

Haemophagocytic lymphohistiocytosis (HLH) results when critical regulation of natural termination of immune/inflammatory responses is disrupted or overwhelmed. The predominant clinical findings of HLH are fevers (often hectic and persistent), pancytopenias, hepatitis and hepatomegaly and splenomegaly. The diagnosis is established by fulfilling one of the HLH 2004 criteria. A 55 years male patient presented with fever, abdominal pain and abdominal distension. Examination revealed cervical lymphadenopathy. and hepato-splenomegaly. Persistent pancytopenia was evident on laboratory investigation, USG showed multiple intra-abdominal lymphnode with necrosis. His bone marrow showed emperepolesis and haemophagocytosis and lymphnode biopsy showed tubercular lymphadenitis. Finally he was diagnosed as secondary HLH with extrapulmonary tuberculosis. Patient managed with Anti tubercular drug and steroid with satisfactory response.HLH is a fatal but curable if diagnosed early and rarely associated with extrapulmonary tuberculosis.

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