Overwhelming primary Epstein-Barr virus infection requiring corticosteroid treatment.
BMJ Case Rep
; 20112011 Oct 28.
Article
em En
| MEDLINE
| ID: mdl-22675096
ABSTRACT
A 20-year-old woman presented with a 2-week history of fever and malaise. Physical examination was unremarkable. Viral infection was suspected and Epstein-Barr virus serology confirmed acute infectious mononucleosis. During admission, she gradually developed pancytopenia and liver enzyme abnormalities. The patient clinically deteriorated with persisting fever, orthostatic hypotension and hepatosplenomegaly. Bone marrow examination showed haemophagocytic lymphohistiocytosis (HLH). Treatment with high-dose corticosteroids was started and patient recovered quickly. Ferritin decreased immediately, fever resolved within 3 days, viral clearance was reached within 3 weeks. Steroid therapy was gradually tapered off in three months. The Histiocyte Society recommends immunochemotherapy with steroids, etoposide and cyclosporine. Potential side effects of etoposide are severe bone marrow depression and leukaemia. Our patient survived on corticosteroids alone. Early recognition of HLH and prompt treatment are of utmost importance for survival. Treatment with steroids alone can be life-saving.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Corticosteroides
/
Linfo-Histiocitose Hemofagocítica
/
Mononucleose Infecciosa
Idioma:
En
Ano de publicação:
2011
Tipo de documento:
Article