Tsutsugamushi disease with hemophagocytosis complicated by Parvovirus B 19 infection.

Miyakawa, Keiko; Ohsugi, Kouji; Sugahara, Satoshi; Kuriyama, Chizuko; Kikuchi, Akio; Ohta, Makoto

doi:10.2169/naika.95.2544

Cited by 9 publications

(6 citation statements)

References 3 publications

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“…Approximately 30 cases [70,[133][134][135][136][137][138][139] of parvovirus B19 infection have been associated with HPS. The most common underlying disease was hereditary spherocytosis.…”

Section: Parvovirusmentioning

confidence: 99%

Viral infections associated with haemophagocytic syndrome

Maakaroun

Moanna

Jacob

et al. 2010

Reviews in Medical Virology

163

101

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Haemophagocytic syndrome (HPS) or haemophagocytic lymphohistiocytosis (HLH) is a rare disease caused by a dysfunction of cytotoxic T cells and NK cells. This T cell/NK cell dysregulation causes an aberrant cytokine release, resulting in proliferation/activation of histiocytes with subsequent haemophagocytosis. Histiocytic infiltration of the reticuloendothelial system results in hepatomegaly, splenomegaly, lymphadenopathy and pancytopenia ultimately leading to multiple organ dysfunctions. Common clinical features include high fevers despite broad spectrum antimicrobials, maculopapular rash, neurological symptoms, coagulopathy and abnormal liver function tests. Haemophagocytic syndrome can be either primary, i.e. due to an underlying genetic defect or secondary, associated with malignancies, autoimmune diseases (also called macrophage activation syndrome) or infections. Infectious triggers are most commonly due to viral infections mainly of the herpes group, with EBV being the most common cause. HPS can be fatal if untreated. Early recognition of the clinical presentation and laboratory abnormalities associated with HPS and prompt initiation of treatment can be life saving. HPS triggered by viral infections generally does not respond to specific antiviral therapy but may be treated with immunosuppressive/immunomodulatory agents and, in refractory cases, with bone marrow transplantation.

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“…Approximately 30 cases [70,[133][134][135][136][137][138][139] of parvovirus B19 infection have been associated with HPS. The most common underlying disease was hereditary spherocytosis.…”

Section: Parvovirusmentioning

confidence: 99%

Viral infections associated with haemophagocytic syndrome

Maakaroun

Moanna

Jacob

et al. 2010

Reviews in Medical Virology

163

101

View full text Add to dashboard Cite

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“…There are 19 published cases of Parvovirus B19‐associated HLH , which are summarized in Table , and an additional three cases published in either German or Japanese, which were not included in this case series . Of these 19, 5 were female, 13 were male, and in one case, gender was not stated.…”

Section: Introductionmentioning

confidence: 99%

A review of blood diseases and cytopenias associated with human parvovirus B19 infection

Kerr

2015

Reviews in Medical Virology

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Parvovirus B19 is a single-stranded DNA virus which preferentially targets the erythroblast resulting in red cell aplasia, which is temporary in immunocompetent persons. Since the discovery of B19 virus in 1975, a wide variety of blood diseases and cytopenias affecting several blood cell lineages have been documented during or following B19 infection. These include cytopenias affecting the erythroid, megakaryoblastoid, myeloid and lymphoid lineages, as well as a variety of bicytopenias, pancytopenia, bone marrow necrosis / fat embolism syndrome, myelodysplastic syndrome, leucoerythroblastopenia, and hemophagocytic lymphohistiocytosis. B19 infection may also complicate and precede the course of acute leukemia, the significance of which remains to be determined. This review describes the current state of knowledge of the abnormalities of individual blood cell lineages encountered during parvovirus B19 infection, over the almost 40 years since its discovery, and reveals some very interesting themes, which improve our understanding of the pathogenesis of B19 infection with particular reference to the bone marrow.

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“…In addition, previous case reports showed that viruses such as EBV, CMV and parvovirus can trigger HPS after scrub typhus infection (Table 1) [141516171819]. Considering the O. tsutsugamushi PCR results in blood was negative in the current case and there have been no reports of doxycycline-resistant O. tsutsugamushi in South Korea, it is unlikely that scrub typhus is the only reason for HPS.…”

Section: Discussionmentioning

confidence: 64%

Epstein-Barr Virus Associated Hemophagocytic Syndrome after Scrub Typhus Infection

et al. 2016

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There have been a small number of cases of scrub typhus-associated hemophagocytic syndrome (HPS), most of which were treated successfully using adequate antibiotics. Here, we report a case of Epstein-Barr virus (EBV)-associated HPS after scrub typhus infection that was not improved using antirickettsial treatment. A 73-year-old male who had been diagnosed with scrub typhus according to an eschar and a positive serology was transferred to our institution because of a persistent fever despite 7-day doxycycline therapy. Physical and laboratory data showed hepatosplenomegaly, bicytopenia, hyperferritinemia, and hypofibrinogenemia. A bone marrow examination (BM) revealed hypercellular marrow with hemophagocytosis and histiocyte infiltration. EBV was detected in BM aspirates using polymerase chain reaction. After a diagnosis of HPS was made, the patient was treated successfully using high-dose steroids.

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Tsutsugamushi disease with hemophagocytosis complicated by Parvovirus B 19 infection.

Cited by 9 publications

References 3 publications

Viral infections associated with haemophagocytic syndrome

Viral infections associated with haemophagocytic syndrome

A review of blood diseases and cytopenias associated with human parvovirus B19 infection

Epstein-Barr Virus Associated Hemophagocytic Syndrome after Scrub Typhus Infection

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