Hemophagocytic Syndrome Secondary to Cytomegalovirus Infection in a Patient with Human Immunodeficiency Virus

Elizabeth Castro; María Cepeda; Diego Ospina

doi:doi:10.11648/j.ejcbs.20210706.16

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Hemophagocytic Syndrome Secondary to Cytomegalovirus Infection in a Patient with Human Immunodeficiency Virus

Elizabeth Castro, María Cepeda, Diego Ospina

Published in European Journal of Clinical and Biomedical Sciences (Volume 7, Issue 6)

Received: 1 September 2021 Accepted: 22 November 2021 Published: 27 November 2021

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Abstract

Hemophagocytic Syndrome (HPS) or Hemophagocytic Lymphohistiocytosis is characterized by a dysregulation of the immune system with activation of macrophages and T lymphocytes, the product of an uncontrollable and excessive inflammatory response to different stimuli. The case of a patient with a history of Human Immunodeficiency Virus (HIV) under current treatment is presented, a clinical picture of 10 days of evolution characterized by fever, anorexia and asthenia, on physical examination skin-mucosa paleness, dehydration, generalized lymphadenopathy, hepatosplenomegaly. Paraclinical tests are performed suggesting reactivation of infection by Cytomegalovirus (CMV), in addition, during its in-hospital evolution, marked pancytopenia is evidenced, with elevated ferritin values, a bone marrow biopsy is performed, observing proliferation of Histiocytes, the patient meets the diagnostic criteria for HPS proposed by the Histiocyte Society in 2004, treatment was instituted, however it presented a torpid evolution and reached death. It is concluded that the diagnosis of HPS is complex; it is usually overlapped by the underlying diseases, as is the case of this HIV patient with reactivation of CMV infection; both viruses by themselves are related to HPS; therefore, knowledge of the clinical and laboratory criteria of this entity is necessary to make an early diagnosis and establish timely treatment, thus reducing mortality.

Published in	European Journal of Clinical and Biomedical Sciences (Volume 7, Issue 6)
DOI	10.11648/j.ejcbs.20210706.16
Page(s)	126-131
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2021. Published by Science Publishing Group

Keywords

Hemophagocytic Syndrome, Hemophagocytic Lymphohistiocytosis, Cytomegalovirus, Human Immunodeficiency Virus

References

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[3]	Warley F., Bonella B., Odstrcil-Bobillo M., Otero V., Waisma G., Bendelman G., Giunta D., Peuchot V., & Ungaro C. (2017). Clinical characteristics and mortality of adult patients with hemaphagocytic syndrome, retrospective cohort study. Rev Med Chile, 145 (3): 344-350.
[4]	Pereira L., Dabezies A., Cuturi B., Fernández A., & Pérez W. (2018). Hemophagocytic lymphohistiocytosis. About a case. Archives of Pediatrics of Uruguay, 89 (2): 122-128.
[5]	Iscano N., & Fajardo F. (2018). Hemophagocytic syndrome. J. Med. Hondur., 86 (3 and 4): 134-137.
[6]	Egües C., Calvo J., Cabrera L., Sola A., Furundarena J., Alcorta N., Valero J., López L., Cancio J., Maiz O., Uriarte E., & Belzunegui J. (2020). Clinical characteristics and prognostic factors in patients with Hemophagocytic syndrome. Int. J. Rare Dis Disorder, 3 (020).
[7]	Dávila D, & Peña IR. (2019). Hemophagocytic syndrome. Case report and literature review. Journal of the Faculty of Medicine of the UNAM, 62 (2): 15-21.
[8]	Rosemberg M., Echavarría G., Ludueña A., Estrada G., & Molina M. (2018). Hemophagocytosis Secondary to Dengue. Medicine, 78 (1): 37-40.
[9]	Santos L., Martínez O., & Milian G. (2017). Hemophagocytic syndrome. Case report and disease review. Medical Certificate of the Center, 11 (4): 38-45.
[10]	Li J., Wang Q., Zheng W., Ma J., Zhang W., Wang W., & Tian X. (2014). Hemophagocytic Linfohistiocytosis. Analysis clinical of 103 adult patients. Medicine, 93 (2): 100-105.
[11]	Espinosa K., García P., Fossas D., & León E. (2013). Hemophagocytic syndrome. Current concepts. Medical Gazette of Mexico, 149: 431-7.
[12]	Parikh S. Kapoor P., Letendre L., Kumar S., & Wolansky A. (2014). Prognostic factors and outcomes in adults with hemophagocytic lymphohistiocytosis. May Clin. Proc, 89 (4): 484-492.
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[14]	Dos Santos G., Uría R., Silvera L., Santos C., Oliver C., Frantchez V., Cichero M., Solari P., Grille S., Sosa L., & Silvariño R. (2017). Hemophagocytic syndrome: a rare complication in the patient with human immunodeficiency virus (HIV) infection. Uruguayan Journal of Internal Medicine, 2 (1): 25-31.
[15]	Rivière S., Galicier L., Coppo P., Marzac C., Aumont C., Lambotte O., & Fardet L. (2014). Reactive Hemophagocytic Syndrome in Adults: A Multicenter Retrospective Analysis of 162 Patients. The American Journal of Medicine, 127 (11): 1118-1125.

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APA Style

Elizabeth Castro, María Cepeda, Diego Ospina. (2021). Hemophagocytic Syndrome Secondary to Cytomegalovirus Infection in a Patient with Human Immunodeficiency Virus. European Journal of Clinical and Biomedical Sciences, 7(6), 126-131. https://doi.org/10.11648/j.ejcbs.20210706.16

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ACS Style

Elizabeth Castro; María Cepeda; Diego Ospina. Hemophagocytic Syndrome Secondary to Cytomegalovirus Infection in a Patient with Human Immunodeficiency Virus. Eur. J. Clin. Biomed. Sci. 2021, 7(6), 126-131. doi: 10.11648/j.ejcbs.20210706.16

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AMA Style

Elizabeth Castro, María Cepeda, Diego Ospina. Hemophagocytic Syndrome Secondary to Cytomegalovirus Infection in a Patient with Human Immunodeficiency Virus. Eur J Clin Biomed Sci. 2021;7(6):126-131. doi: 10.11648/j.ejcbs.20210706.16

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@article{10.11648/j.ejcbs.20210706.16,
  author = {Elizabeth Castro and María Cepeda and Diego Ospina},
  title = {Hemophagocytic Syndrome Secondary to Cytomegalovirus Infection in a Patient with Human Immunodeficiency Virus},
  journal = {European Journal of Clinical and Biomedical Sciences},
  volume = {7},
  number = {6},
  pages = {126-131},
  doi = {10.11648/j.ejcbs.20210706.16},
  url = {https://doi.org/10.11648/j.ejcbs.20210706.16},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ejcbs.20210706.16},
  abstract = {Hemophagocytic Syndrome (HPS) or Hemophagocytic Lymphohistiocytosis is characterized by a dysregulation of the immune system with activation of macrophages and T lymphocytes, the product of an uncontrollable and excessive inflammatory response to different stimuli. The case of a patient with a history of Human Immunodeficiency Virus (HIV) under current treatment is presented, a clinical picture of 10 days of evolution characterized by fever, anorexia and asthenia, on physical examination skin-mucosa paleness, dehydration, generalized lymphadenopathy, hepatosplenomegaly. Paraclinical tests are performed suggesting reactivation of infection by Cytomegalovirus (CMV), in addition, during its in-hospital evolution, marked pancytopenia is evidenced, with elevated ferritin values, a bone marrow biopsy is performed, observing proliferation of Histiocytes, the patient meets the diagnostic criteria for HPS proposed by the Histiocyte Society in 2004, treatment was instituted, however it presented a torpid evolution and reached death. It is concluded that the diagnosis of HPS is complex; it is usually overlapped by the underlying diseases, as is the case of this HIV patient with reactivation of CMV infection; both viruses by themselves are related to HPS; therefore, knowledge of the clinical and laboratory criteria of this entity is necessary to make an early diagnosis and establish timely treatment, thus reducing mortality.},
 year = {2021}
}

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TY  - JOUR
T1  - Hemophagocytic Syndrome Secondary to Cytomegalovirus Infection in a Patient with Human Immunodeficiency Virus
AU  - Elizabeth Castro
AU  - María Cepeda
AU  - Diego Ospina
Y1  - 2021/11/27
PY  - 2021
N1  - https://doi.org/10.11648/j.ejcbs.20210706.16
DO  - 10.11648/j.ejcbs.20210706.16
T2  - European Journal of Clinical and Biomedical Sciences
JF  - European Journal of Clinical and Biomedical Sciences
JO  - European Journal of Clinical and Biomedical Sciences
SP  - 126
EP  - 131
PB  - Science Publishing Group
SN  - 2575-5005
UR  - https://doi.org/10.11648/j.ejcbs.20210706.16
AB  - Hemophagocytic Syndrome (HPS) or Hemophagocytic Lymphohistiocytosis is characterized by a dysregulation of the immune system with activation of macrophages and T lymphocytes, the product of an uncontrollable and excessive inflammatory response to different stimuli. The case of a patient with a history of Human Immunodeficiency Virus (HIV) under current treatment is presented, a clinical picture of 10 days of evolution characterized by fever, anorexia and asthenia, on physical examination skin-mucosa paleness, dehydration, generalized lymphadenopathy, hepatosplenomegaly. Paraclinical tests are performed suggesting reactivation of infection by Cytomegalovirus (CMV), in addition, during its in-hospital evolution, marked pancytopenia is evidenced, with elevated ferritin values, a bone marrow biopsy is performed, observing proliferation of Histiocytes, the patient meets the diagnostic criteria for HPS proposed by the Histiocyte Society in 2004, treatment was instituted, however it presented a torpid evolution and reached death. It is concluded that the diagnosis of HPS is complex; it is usually overlapped by the underlying diseases, as is the case of this HIV patient with reactivation of CMV infection; both viruses by themselves are related to HPS; therefore, knowledge of the clinical and laboratory criteria of this entity is necessary to make an early diagnosis and establish timely treatment, thus reducing mortality.
VL  - 7
IS  - 6
ER  -

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Author Information

Elizabeth Castro

Faculty of Medicine, University of Zulia, Maracaibo, Venezuela
María Cepeda

Faculty of Medicine, University of Zulia, Maracaibo, Venezuela
Diego Ospina

Faculty of Medicine, University of Zulia, Maracaibo, Venezuela

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APA Style

Elizabeth Castro, María Cepeda, Diego Ospina. (2021). Hemophagocytic Syndrome Secondary to Cytomegalovirus Infection in a Patient with Human Immunodeficiency Virus. European Journal of Clinical and Biomedical Sciences, 7(6), 126-131. https://doi.org/10.11648/j.ejcbs.20210706.16

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ACS Style

Elizabeth Castro; María Cepeda; Diego Ospina. Hemophagocytic Syndrome Secondary to Cytomegalovirus Infection in a Patient with Human Immunodeficiency Virus. Eur. J. Clin. Biomed. Sci. 2021, 7(6), 126-131. doi: 10.11648/j.ejcbs.20210706.16

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AMA Style

Elizabeth Castro, María Cepeda, Diego Ospina. Hemophagocytic Syndrome Secondary to Cytomegalovirus Infection in a Patient with Human Immunodeficiency Virus. Eur J Clin Biomed Sci. 2021;7(6):126-131. doi: 10.11648/j.ejcbs.20210706.16

Copy | Download

@article{10.11648/j.ejcbs.20210706.16,
  author = {Elizabeth Castro and María Cepeda and Diego Ospina},
  title = {Hemophagocytic Syndrome Secondary to Cytomegalovirus Infection in a Patient with Human Immunodeficiency Virus},
  journal = {European Journal of Clinical and Biomedical Sciences},
  volume = {7},
  number = {6},
  pages = {126-131},
  doi = {10.11648/j.ejcbs.20210706.16},
  url = {https://doi.org/10.11648/j.ejcbs.20210706.16},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ejcbs.20210706.16},
  abstract = {Hemophagocytic Syndrome (HPS) or Hemophagocytic Lymphohistiocytosis is characterized by a dysregulation of the immune system with activation of macrophages and T lymphocytes, the product of an uncontrollable and excessive inflammatory response to different stimuli. The case of a patient with a history of Human Immunodeficiency Virus (HIV) under current treatment is presented, a clinical picture of 10 days of evolution characterized by fever, anorexia and asthenia, on physical examination skin-mucosa paleness, dehydration, generalized lymphadenopathy, hepatosplenomegaly. Paraclinical tests are performed suggesting reactivation of infection by Cytomegalovirus (CMV), in addition, during its in-hospital evolution, marked pancytopenia is evidenced, with elevated ferritin values, a bone marrow biopsy is performed, observing proliferation of Histiocytes, the patient meets the diagnostic criteria for HPS proposed by the Histiocyte Society in 2004, treatment was instituted, however it presented a torpid evolution and reached death. It is concluded that the diagnosis of HPS is complex; it is usually overlapped by the underlying diseases, as is the case of this HIV patient with reactivation of CMV infection; both viruses by themselves are related to HPS; therefore, knowledge of the clinical and laboratory criteria of this entity is necessary to make an early diagnosis and establish timely treatment, thus reducing mortality.},
 year = {2021}
}

Copy | Download

TY  - JOUR
T1  - Hemophagocytic Syndrome Secondary to Cytomegalovirus Infection in a Patient with Human Immunodeficiency Virus
AU  - Elizabeth Castro
AU  - María Cepeda
AU  - Diego Ospina
Y1  - 2021/11/27
PY  - 2021
N1  - https://doi.org/10.11648/j.ejcbs.20210706.16
DO  - 10.11648/j.ejcbs.20210706.16
T2  - European Journal of Clinical and Biomedical Sciences
JF  - European Journal of Clinical and Biomedical Sciences
JO  - European Journal of Clinical and Biomedical Sciences
SP  - 126
EP  - 131
PB  - Science Publishing Group
SN  - 2575-5005
UR  - https://doi.org/10.11648/j.ejcbs.20210706.16
AB  - Hemophagocytic Syndrome (HPS) or Hemophagocytic Lymphohistiocytosis is characterized by a dysregulation of the immune system with activation of macrophages and T lymphocytes, the product of an uncontrollable and excessive inflammatory response to different stimuli. The case of a patient with a history of Human Immunodeficiency Virus (HIV) under current treatment is presented, a clinical picture of 10 days of evolution characterized by fever, anorexia and asthenia, on physical examination skin-mucosa paleness, dehydration, generalized lymphadenopathy, hepatosplenomegaly. Paraclinical tests are performed suggesting reactivation of infection by Cytomegalovirus (CMV), in addition, during its in-hospital evolution, marked pancytopenia is evidenced, with elevated ferritin values, a bone marrow biopsy is performed, observing proliferation of Histiocytes, the patient meets the diagnostic criteria for HPS proposed by the Histiocyte Society in 2004, treatment was instituted, however it presented a torpid evolution and reached death. It is concluded that the diagnosis of HPS is complex; it is usually overlapped by the underlying diseases, as is the case of this HIV patient with reactivation of CMV infection; both viruses by themselves are related to HPS; therefore, knowledge of the clinical and laboratory criteria of this entity is necessary to make an early diagnosis and establish timely treatment, thus reducing mortality.
VL  - 7
IS  - 6
ER  -

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