Hemophagocytic lymphohistiocytosis: An unusual presentation of tuberculosis in hemodialysis patients
Citations Over Time
Abstract
We report a series of three patients with end-stage renal disease on maintenance hemodialysis presenting with hemophagocytic lymphohistiocytosis (HLH) as an unusual manifestation of extrapulmonary tuberculosis. All three patients were middle-aged men. They presented with fever, pancytopenia, varying degrees of hepatosplenomegaly, abnormal liver function tests, coagulopathy, increased serum ferritin, and triglycerides. Tests for fever work-up were negative. Bone marrow examination revealed hemophagocytosis and caseating granuloma. Acid fast bacilli were demonstrated in two patients. The HLH-2004 diagnostic criteria suggested by the histiocytic society were followed to arrive at the diagnosis. All of them succumbed to death even before the definitive diagnosis could be made. We suggest that aggressive diagnostic work-up must be done when hemodialysis patients present with fever and pancytopenia. Priority should be toward early diagnosis and appropriate treatment to improve the prognosis.
Related Papers
- → Pancytopenia resulting from hemophagocytosis in malaria(2002)27 cited
- → Histoplasmosis on bone marrow aspirate cytological examination associated with hemophagocytosis and pancytopenia in an AIDS patient(2012)24 cited
- → Pancytopenia and Hepatosplenomegaly in Oxalosis(1984)22 cited
- → Brucellosis presenting with pancytopenia due to hemophagocytic syndrome(2011)4 cited
- Brucellosis presenting with pancytopenia due to hemophagocytic syndrome Hemofagositik sendroma bağli pansitopeni ile başvuran bruselloz olgusu(2011)