Neurological presentation of hemophagocytic lymphohistiocytosis

Abstract

Hemophagocytic lymphohistiocytosis (HLH) is an inflammatory disorder arising from defects in critical regulatory pathways responsible for termination of inflammatory response. We are presenting a case report of a 20-year-old male, admitted to the Department of Neurology because of left lower limb weakness and balance disturbances. After a few days of hospitalization, fever occurred. Laboratory tests revealed anemia, neutropenia, lymphopenia, and thrombocytopenia. The clinical course and laboratory tests results confirmed the diagnosis of HLH. In our opinion, the disorder in the presented case occurred due to severe chronic active Epstein-Barr virus infection syndrome. We are presenting the case of pure neurological onset of hemophagocytic lymphohistiocytosis in an adult patient. Hemophagocytic lymphohistiocytosis, initially presenting with neurological symptoms, can occur in adult patients with irrelevant family history. It is a life-threatening but potentially curable condition requiring proper diagnostic and treatment management.

Ototoxicity, a rare but reversible adverse effect of a commonly used antimicrobial agent

“…Apart from leishmaniasis and AMB, the other confounding illness our patient had was the presence of HLH. Though neurological manifestations in the form of weakness, sensory loss or other focal neurological deficits have been reported with HLH,9 ototoxicity was never reported. Apart from the obvious reason that HLH and its manifestations were on improving trends, the possibility of HLH causing ototoxicity was less likely.…”