Macrophage activation syndrome in malaria

Dass, Rashna; Barman, Himesh; Duwarah, Sourabh Gohain; Choudhury, Vivek; Jain, Pankaj; Deka, Nayan Mani; Murari, Manjula

doi:10.1007/s00296-009-1033-1

Cited by 7 publications

(7 citation statements)

References 14 publications

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“…Malarial parasite was not observed in bone marrow in our case. Even, in the previous reported 12 cases of falciparum induced HLH, only 1 case had the demonstrable parasite in bone marrow as shown in Table 2b [11][12][13][14][15][16][17][18][19][20][21][22][23][24] but still malaria was considered to be the most likely cause of HLH due to temporal relationship to the illness. In our case serum LDH levels were also elevated, which, although not included in the diagnostic criteria, but have also been found to be elevated in cases of HLH reported by other studies [14].…”

Section: Discussionmentioning

confidence: 99%

“…In majority of the reported cases of HLH secondary to malaria, complete recovery has been observed even when the patient received the antimalarial treatment alone, while, few required additional immunosuppression. However, no death has been reported due to falciparum malaria associated HLH as shown in Table 2b [11][12][13][14][15][16][17][18][19][20][21][22][23][24].…”

Section: Discussionmentioning

confidence: 99%

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Fatal Case of Haemophagocytic Syndrome Associated With Infection of Plasmodium Falciparum

Agale¹

2018

HIJ

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Haemophagocytic lymphohistiocytosis (HLH) is a hyperinflammatory condition which can occur as a primary syndrome (genetic in origin) or arise secondary to infectious, rheumatologic, malignant or metabolic disorders. HLH is characterised by hypercytokinemia and organ infiltration by phagocytozing histiocytes leading to tissue damage. This entity is often under-diagnosed, especially in adults, and specific therapy is not considered early in the disease course. We report a rare and unusual case of haemophagocytic lymphohistiocytosis (HLH) associated with infection by Plasmodium falciparum. The bone marrow aspiration and biopsy showed proliferation of histiocytes with engulfed haematopoietic cells, however patient succumbed to death before treatment for HLH could be started. Thus, this case report emphasizes the need for consideration of diagnosis of HLH in adult patients so as to provide timely diagnosis and prompt treatment to improve the clinical outcome.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Fatal Case of Haemophagocytic Syndrome Associated With Infection of Plasmodium Falciparum

Agale¹

2018

HIJ

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“…The association between MAS and malaria has been occasionally found in adults (8)(9). Whereas, only two cases are reported in previously healthy adolescents affected with malaria and complicated by hemophagocytosis (3,4). Moreover, malaria has been described as triggering a hemophagocytic syndrome in a boy with Langerhans cell histiocytosis (10).…”

Section: Discussionmentioning

confidence: 99%

“…However, it is known to occur in a heterogeneous group of diseases including malignancy, immunodeficiency, hematological and infectious diseases. Malaria has been very rarely described as complicated by MAS; few cases of MAS during malaria have been reported in childhood (3,4). Therefore, we report the case of a 6-year-old boy who developed MAS during malaria.…”

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confidence: 91%

Macrophage Activation Syndrome in a Child Affected by Malaria: The Choice of Steroid

Trapani

Canessa

Fedi

et al. 2013

Int J Immunopathol Pharmacol

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Macrophage activation syndrome is a potentially fatal clinical syndrome caused by an excessive activation and proliferation of macrophages and T cells, leading to an exaggerated inflammatory reaction. It is well known that it can complicate the course of different conditions, especially autoimmune, lympho-proliferative, infectious diseases and drugs. Many infective pathogens can trigger the syndrome but the association with malaria has rarely been described, especially in children. We report a child with severe malaria complicated by MAS, in whom the clinical appearance of this syndrome could be considered as worsening of malaria itself. Furthermore, the use of steroids as first choice drugs in this complication, but arguable in malaria, has been highlighted. Clinicians should be aware of this syndrome when malaria does not respond to conventional therapy, since early diagnosis and prompt treatment may dramatically reduce the mortality associated with this condition.

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“…Malaria as a cause of secondary HLH is rare. The literature search yielded 17 studies (18 patients) reporting on patients with HLH secondary to malaria ( Table II ) 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 . A majority of the described cases have reported only six of the eight criteria used for HLH, and investigations to look for natural killer cell activity and soluble CD25 antigen levels were not available in most cases except one 11 .…”

mentioning

confidence: 99%