Secondary hemophagocytic lymphohistiocytosis in children with brucellosis: report of three cases

Abstract

Brucellosis is a systemic zoonotic infectious disease that may cause fever, fatigue, sweating, arthritis, hepatosplenomegaly, cytopenia, and lymphadenopathy. It continues to be an important health problem worldwide. Hemophagocytic lymphohistiocytosis (HLH) is characterized by fever, hepatosplenomegaly, cytopenias, high serum levels of ferritin and triglycerides, low serum fibrinogen levels, and hemophagocytosis in bone marrow, lymph nodes, spleen, or liver. Hemophagocytic lymphohistiocytosis associated with brucellosis is a very rare condition in the pediatric age group. Here, three pediatric cases of secondary HLH associated with brucellosis are reported. Hemophagocytic lymphohistiocytosis should be considered in patients with brucellosis having cytopenias. Hemophagocytosis in brucellosis seems to be cured with appropriate antibiotics and intravenous immunoglobulin.

Brucellosis-Induced Hemophagocytic Lymphohistiocytosis

“…Yaman reported three children with this diagnosis who had a similar presentation to our patient. In addition to standard anti-Brucella therapy, they received intravenous immunoglobulins (IVIG) to manage severe thrombocytopenia despite that evidence for the role of IVIG in the management of HLH is lacking [18]. The treatment of HLH depends on the underlying diseases and the severity of the symptoms.…”

Infection associated hemophagocytic syndrome in children: a retrospective analysis of 15 cases

“…HFS'nin tipik klinik bulguları olan uzamış ateş ve sitopeni bizim olgularımızın tümünde (%100), splenomegali %80'inde mevcuttu. Uzamış ateş, sitopeni ve organomegali gibi klinik bulguların bruselloz ve leishmaniazis gibi enfeksiyon hastalıklarında da görülmesi HFS tanısını geciktirebilmektedir [12,13]. Bu nedenle enfeksiyon nedeniyle izlenen hastalarda uzamış ateş, organomegali, sitopeninin varlığı ve klinik durumda hızla kötüye gidiş hekime HFS olasılığını da akla getirmelidir [4,8].…”

Hemophagocytic lymphohistiocytosis in a patient with Sjögren’s syndrome: case report and review

“…Some examples of bacterial etiologies are mycobacteria, Brucella, Rickettsia, Hemophilus influenzae and Serratia sp. The most common parasites are Leishmania and Toxoplasma [22][23][24][25][26][27][28][29][30].…”