Parvovirus B19‐induced hemophagocytic lymphohistiocytosis: Case report and review of the literature

Abstract

HLH is a catastrophic and likely underdiagnosed pathology with multiple triggers including infection. PVB19 can cause persistent marrow infection leading to HLH despite negative acute serologic markers making timely diagnosis difficult. Increased awareness of PVB19‐HLH is warranted given its potentially lethal nature and the careful interpretation required with serologic markers.

Hemophagocytic lymphohistiocytosis and thrombotic microangiopathy after parvovirus B19 infection and renal transplantation: a case report

“…When we tested the patient for viral infections on first admission, multiple PCR assays for PVB19 were negative. However other authors demonstrated that in some individuals PVB19 infection is only detectable in bone marrow samples whereas serum diagnostic can still be negative [ 9 , 10 ]. In our case it is likely that PVB19 infection was already ongoing when the patient was admitted to our hospital.…”

“…systemic lupus erythematosus) or malignancies [ 2 ]. A few cases of HLH due to PVB19 infection have previously been described, including one patient who had received renal transplantation [ 7 , 10 , 11 ].…”

Purpuric rash in an adolescent with fever, pancytopenia, and an hemophagocytic lymphohistiocytosis‐like syndrome due to parvovirus B19

“…There are approximately 30 cases of HLH triggered by parvovirus B19 reported in the literature thus far 16,17 . It appears that in the majority of these cases, the patients survived without any specific therapy for HLH, which shows that the parvovirus‐triggered HLH carries a better prognosis 16 …”

“…16 There are approximately 30 cases of HLH triggered by parvovirus B19 reported in the literature thus far. 16,17 It appears that in the majority of these cases, the patients survived without any specific therapy for HLH, which shows that the parvovirus-triggered HLH carries a better prognosis. 16 It is possible that the prompt administration of IVIG reversed the situation at an early stage by alleviating the manifestations of the infection.…”

Hemophagocytic lymphohistiocytosis after trauma

“…Secondary HLH can occur in all age groups. Its development can be related to viral (EBV, CMV, Parvovirus, Herpes simplex, Varicella zoster, Rubella, HHV8, HIV), bacterial (Brucella, tbc), parasitic (Leishmania) and fungal infections, as well as malignancy (leukemia and large cell anaplastic lymphoma), metabolic diseases ( lysinuric protein intolerance and multiple sulfatase deficiency), immunodeficiency and collagen tissue diseases, inflammatory bowel diseases, sarcoidosis and Kawasaki disease [2].…”