Hemophagocytosis on ascitic fluid cytology: Diagnosis of <scp>HLH</scp>

Shaar, Rand Abou; Perry, Kyle; Otrock, Zaher K.

doi:10.1002/dc.24999

Cited by 1 publication

(1 citation statement)

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“…However, hemophagocytosis may not be detected by bone marrow biopsy in the early stages of HLH and may not appear until later in the course of the disease. 21 As reported by Carter et al 22 and Thompson et al 23 repeated bone marrow biopsies may be required for confirmation. It is important to note that bone marrow hemophagocytosis may not be specific to HLH, but may be a physiological manifestation after blood transfusion or surgery, or may occur in infections, malignancies, and other acute diseases.…”

Section: Discussionmentioning

confidence: 89%

A Case Report of Pregnancy Complicated with Primary Hemophagocytic Lymphohistiocytosis

Chen,

Huang,

Chen

et al. 2024

IJWH

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Background Hemophagocytic lymphohistiocytosis (HLH) is a severe hyperinflammatory syndrome characterized by excessive activation of NK cells and cytotoxic T lymphocytes, subsequently leading to macrophage activation and increased cytokine production. Misdiagnosis due to nonspecific clinical presentations and inadequate understanding of the disease can significantly jeopardize the safety of both the mother and the infant. We report a case of pregnancy combined with HLH and conduct a literature review to provide insights into the diagnosis and treatment of pregnancy-related HLH. Case Presentation We discussed a case of a pregnant woman with persistent postpartum fever, serum ferritin, and elevated liver function, who failed to respond to repeated anti-infective therapy and was diagnosed with HLH after multidisciplinary diagnostic treatment. We gave dexamethasone treatment, and the patient’s temperature and blood cells quickly returned to normal. Finally, exome sequencing revealed heterozygous variation in UNC13D gene, so we considered this case as pregnancy combined with primary HLH (pHLH). Conclusion We report the case of HLH diagnosed during pregnancy and show that early diagnosis and timely intervention can prevent rapid disease progression, reduce maternal mortality rates, and improve survival rates. Additionally, molecular genetic testing can confirm pathogenic gene mutations, providing essential genetic counseling for patients with pHLH who plan to conceive a healthy child.

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Section: Discussionmentioning

confidence: 89%