Thrombotic Microangiopathy Due to Progressive Disseminated Histoplasmosis in a Child With Down Syndrome and Acute Lymphoblastic Leukemia.
J Pediatr Hematol Oncol
; 45(1): 38-40, 2023 01 01.
Article
en En
| MEDLINE
| ID: mdl-36162003
ABSTRACT
Histoplasmosis, a common mycosis in the south-central United States, may be life threatening in immunocompromised patients. We describe a 4-year-old female with Down syndrome and acute lymphoblastic leukemia who developed hemolytic anemia, thrombocytopenia, and renal failure, consistent with thrombotic microangiopathy. Bone marrow biopsy revealed non-necrotizing granulomas with GMS staining demonstrating budding yeast. Serum Histoplasma antigen testing was positive, providing further evidence for the diagnosis of progressive disseminated histoplasmosis. Treatment with amphotericin B, plasma exchange, and ventilator, vasopressor, and renal replacement support led to a full recovery. Providers should have a low threshold for histoplasmosis testing in ill immunocompromised patients, who are at greater risk for infection-related morbidity.
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Síndrome de Down
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Leucemia-Linfoma Linfoblástico de Células Precursoras
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Microangiopatías Trombóticas
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Histoplasmosis
Límite:
Child
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Child, preschool
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Female
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Humans
Idioma:
En
Año:
2023
Tipo del documento:
Article