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Hemophagocytic syndrome in a patient with disseminated tuberculosis: a case report

Vania Lombardo, Fania Puccia, Antonino Terranova, Andrea Affronti, Ada Maria Florena, Lydia Giannitrapani, Maurizio Soresi
  • Vania Lombardo
    Biomedical Department of Internal Medicine and Specialities, University-Hospital of Palermo, Italy | maurizio.soresi@unipa.it
  • Fania Puccia
    Biomedical Department of Internal Medicine and Specialities, University-Hospital of Palermo, Italy
  • Antonino Terranova
    Biomedical Department of Internal Medicine and Specialities, University-Hospital of Palermo, Italy
  • Andrea Affronti
    Biomedical Department of Internal Medicine and Specialities, University-Hospital of Palermo, Italy
  • Ada Maria Florena
    Department of Sciences for Health Promotion, Section of Pathology, University-Hospital of Palermo, Italy
  • Lydia Giannitrapani
    Biomedical Department of Internal Medicine and Specialities, University-Hospital of Palermo, Italy
  • Maurizio Soresi
    Biomedical Department of Internal Medicine and Specialities, University-Hospital of Palermo, Italy

Abstract

Hemophagocytic syndrome (HS) is a rare disorder of the immune system. It is characterized by fever, lymphadenopathy, hepatosplenomegaly, cytopenia and hyperferritinemia. The cause differs in each country suggesting a specific genetic background and epidemiology of infections, and it can be associated with malignant diseases. A rare cause of HS is tuberculosis (TB), we describe a case of HS associated with disseminated Mycobacterium tuberculosis (MT) infection in a patient from Sudan. He presented diarrhea, fever, pancytopenia, thickened and dilated bowel loops and lymph nodes enlargement at ultrasound and computed tomography scan. A bone marrow biopsy performed to rule out a lymphoma revealed a HS. The bronchoalveolar lavage (BAL) culture was then positive for MT and subsequently, radiologic aspects of lung and spleen TB involvement appeared. A disseminated tuberculosis was diagnosed. Despite antituberculous therapy, the patient died as in approximately 50% of the HS associated with TB.

Keywords

Hemophagocytic syndrome; hemophagocytic lymphohistiocytosis disseminated tuberculosis; Mycobacterium tuberculosis.

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Submitted: 2017-10-04 23:56:37
Published: 2018-03-20 17:25:09
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Copyright (c) 2018 Vania Lombardo, Fania Puccia, Antonino Terranova, Andrea Affronti, Ada Maria Florena, Lydia Giannitrapani, Maurizio Soresi

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