Clin Pediatr Hematol Oncol.  2016 Oct;23(2):179-183. 10.15264/cpho.2016.23.2.179.

Adenovirus-induced Hemophagocytic Lymphohistiocytosis in a Previously Healthy Boy: A Case Report and Literature Review

• Seo YH
• Shim YJ
• Kim HS
• Lee HJ
• Jeon DS
• Im HJ

• KMID: 2358376
• DOI: http://doi.org/10.15264/cpho.2016.23.2.179

Abstract

A 3-year-old previously healthy boy was admitted because of a 1-week history of fever, abdominal pain, vomiting, and diarrhea. The initial laboratory tests showed hepatic dysfunction with disseminated intravascular coagulation. There was a large amount of pleural effusion, periportal edema, minimal ascites, and splenomegaly. He was initially managed with broad spectrum antibiotics with transfusion. Despite 2 days of treatment, the fever persisted and the results of the laboratory tests had worsened. Bacterial cultures from the blood, urine, pleural effusion, and ascites were all negative. He was finally diagnosed with hemophagocytic lymphohistiocytosis (HLH) based on the diagnostic criteria. Adenovirus was detected in the initial diarrhea and nasal swab specimens using polymerase chain reaction-based method. One year after chemotherapy with dexamethasone, cyclosporine, and etoposide, he is now healthy without evidence of disease recurrence. This is the first Korean case report of adenovirus-induced HLH in a previously healthy child.

Keyword

Adenovirus; Hemophagocytic lymphohistiocytosis; Immunocompetent; Infection-associated hemophagocytic syndrome

MeSH Terms

Abdominal Pain
Adenoviridae
Anti-Bacterial Agents
Ascites
Child
Child, Preschool
Cyclosporine
Dexamethasone
Diarrhea
Disseminated Intravascular Coagulation
Drug Therapy
Edema
Etoposide
Fever
Humans
Lymphohistiocytosis, Hemophagocytic*
Male*
Methods
Pleural Effusion
Recurrence
Splenomegaly
Vomiting
Anti-Bacterial Agents
Cyclosporine
Dexamethasone
Etoposide