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A Case of Hemophagocytic Lymphohistiocytosis Presenting with Neck Mass in a Child

경부 종괴를 동반한 소아에서의 혈구탐식성 림프조직구증 1례

  • Kil, Bu Kwan (Department of Otorhinolaryngology-Head and Neck Surgery, School of Medicine, Catholic University of Daegu) ;
  • Lee, Dong Won (Department of Otorhinolaryngology-Head and Neck Surgery, School of Medicine, Catholic University of Daegu) ;
  • Kim, Jeong Kyu (Department of Otorhinolaryngology-Head and Neck Surgery, School of Medicine, Catholic University of Daegu)
  • 길부관 (대구가톨릭대학교 의과대학 이비인후과학교실) ;
  • 이동원 (대구가톨릭대학교 의과대학 이비인후과학교실) ;
  • 김정규 (대구가톨릭대학교 의과대학 이비인후과학교실)
  • Received : 2020.07.08
  • Accepted : 2020.11.01
  • Published : 2020.11.30

Abstract

Hemophagocytic lymphohistiocytosis (HLH) is a rare but life-threatening one syndrome of excessive immune activation. This immune dysregulation disorder is prominently associated with cytopenias and combinations of clinical signs and extreme inflammation symptoms. For survival, it is important to diagnose early and treat appropriately. We report a case of 10 years old boy who was admitted to the hospital with a month history of fever and cervical lymph node enlargement. There were signs of hemophagocytic histiocytosis in the lymph node and bone marrow. The etiology, diagnosis, and treatment of hemophagocytic lymphohistiocytosis are reviewed.

Keywords

References

  1. Bergsten E, Horne A, Arico M, Astigarraga I, Egeler R, Filipovich A et al. Confirmed efficacy of etoposide and dexamethasone in HLH treatment: long-term results of the cooperative HLH-2004 study. Blood 2017;130:2728-2738. https://doi.org/10.1182/blood-2017-06-788349
  2. Filipovich A, McClain K, Grom A. Histiocytic disorders: recent insights into pathophysiology and practical guidelines. Biol Blood Marrow Transplant 2010;16:S82-89. https://doi.org/10.1016/j.bbmt.2009.11.014
  3. Henter JI, Horne A, Arico M, Egeler R, Filipovich A, Imashuku S et al. HLH-2004: Diagnostic and therapeutic guidelines for hemophagocytic lymphohistiocytosis. Pediatr Blood Cancer 2007;48:124-131. https://doi.org/10.1002/pbc.21039
  4. H K Rosenberg, R I Markowitz, H Kolberg, C Park, A Hubbard, R D Bellah. Normal splenic size in infants and children: sonographic measurements. AJR Am J Roentgenol. 1991;157:119-121. https://doi.org/10.2214/ajr.157.1.2048509
  5. Oguz MM, Sahin G, Altinel Acoglu E, Polat E, Yucel H, Celebi F et al. Secondary hemophagocytic lymphohistiocytosis in pediatric patients: a single center experience and factors that influenced patient prognosis. Pediatr Hematol Oncol 2019;36:1-16. https://doi.org/10.1080/08880018.2019.1572253
  6. Ishii E. Hemophagocytic Lymphohistiocytosis in Children: Pathogenesis and Treatment. Front Pediatr 2016;4:47. https://doi.org/10.3389/fped.2016.00047
  7. Machowicz R, Janka G, Wiktor-Jedrzejczak W. Similar but not the same: Differential diagnosis of HLH and sepsis. Crit Rev Oncol Hematol 2017;114:1-12. https://doi.org/10.1016/j.critrevonc.2017.03.023
  8. Marsh RA, Haddad E. How i treat primary haemophagocytic lymphohistiocytosis. Br J Haematol 2018;182:185-199. https://doi.org/10.1111/bjh.15274
  9. Hong HJ. Pediatric Neck Mass. Korean Journal of Otorhinolaryngology-Head and Neck Surgery 2016;59:88-95. https://doi.org/10.3342/kjorl-hns.2016.59.2.88
  10. Kim DS. Clinical characteristics and prognostic factors for survival in hemophagocytic lymphohiosiocytosis. Korean Journal of Pediatrics 2008;51:299-306. https://doi.org/10.3345/kjp.2008.51.3.299
  11. Lim GY. Hemophagocytic lymphohistiocytosis preceded by Kikuchi disease in children. Pediatric Radiol 2008;38:756-761. https://doi.org/10.1007/s00247-008-0894-x
  12. Kim HS. A Case of Kikuchi's disease associated with hemophagocytic syndrome. Korean Journal of Otorhinolaryngology- Head and Neck Surgery 2011;54:859-861. https://doi.org/10.3342/kjorl-hns.2011.54.12.859
  13. Suresh N et al. Hemophagocytic Lymphohistiocytosis Masking the Diagnosis of Lymphoma in an Adolescent Male. Indian J Hematol Blood Transfus 2014;30(Suppl 1):135-137. https://doi.org/10.1007/s12288-013-0291-y
  14. Lelii M et al. Kikuchi-Fujimoto disease in children: two case reports and a review of the literature. Italian Journal of Pediatrics 2018:44-83.
  15. Vithoosan S et al. Kikuchi-Fujimoto disease associated with systemic lupus erythematosus complicated with hemophagocytic lymphohistiocytosis: a case report. Journal of Medical Case Reports 2019;13:173. https://doi.org/10.1186/s13256-019-2100-1