RESUMEN
We present a case of a 4.5-month-old boy from Turkey with hemophagocytic lymphohistiocytosis (HLH) associated with H1N1 virus and Leishmania spp. coinfection. Because visceral leishmaniasis can mimic hematologic disorders like HLH, it is important to rule out this clinical condition before starting immunosuppressive therapy. In our case, treatment with liposomal amphotericin B resulted in a dramatic resolution of clinical and laboratory abnormalities.
Asunto(s)
Subtipo H1N1 del Virus de la Influenza A , Gripe Humana/complicaciones , Leishmaniasis Visceral/complicaciones , Linfohistiocitosis Hemofagocítica/complicaciones , Anfotericina B/uso terapéutico , Antiprotozoarios/uso terapéutico , Preescolar , Humanos , Gripe Humana/diagnóstico , Gripe Humana/tratamiento farmacológico , Leishmaniasis Visceral/diagnóstico , Leishmaniasis Visceral/tratamiento farmacológico , Linfohistiocitosis Hemofagocítica/diagnóstico , MasculinoRESUMEN
Pseudotumor cerebri with or without venous sinus thrombosis is a rare clinical presentation of Behçet disease in childhood. We present here a case of childhood pseudotumor cerebri without a previous diagnosis of Behçet disease. The detailed history and physical examination of the case led to the diagnosis of neuro-Behçet disease. The investigation of predisposition to thrombosis revealed heterozygous factor V Leiden mutation along with the high lipoprotein(a) level. The symptoms resolved dramatically by treatment with the combination of immunosuppression and anticoagulation with regard to the detected factor V Leiden mutation and high lipoprotein(a) level. After a symptom-free period of 9 months, the cerebral vein thrombosis recurred. We present this case to draw attention to this rare cause of pseudotumor cerebri in childhood and to emphasize the importance of additional thrombotic risk factors regarding the potential recurrence of thrombotic events in Behçet disease.
Asunto(s)
Síndrome de Behçet/genética , Seudotumor Cerebral/genética , Trombosis de los Senos Intracraneales/genética , Edad de Inicio , Síndrome de Behçet/complicaciones , Síndrome de Behçet/epidemiología , Niño , Factor V/genética , Femenino , Humanos , Lipoproteína(a)/sangre , Seudotumor Cerebral/tratamiento farmacológico , Seudotumor Cerebral/epidemiología , Recurrencia , Trombosis de los Senos Intracraneales/tratamiento farmacológico , Trombosis de los Senos Intracraneales/epidemiología , Resultado del TratamientoRESUMEN
We present a case of a 4.5-month-old boy from Turkey with hemophagocytic lymphohistiocytosis (HLH) associated with H1N1 virus and Leishmania spp. coinfection. Because visceral leishmaniasis can mimic hematologic disorders like HLH, it is important to rule out this clinical condition before starting immunosuppressive therapy. In our case, treatment with liposomal amphotericin B resulted in a dramatic resolution of clinical and laboratory abnormalities.
É relatado um caso de um menino de 4,5 meses de idade, da Turquia, com linfohistiocitose hemofagocítica (HLH) associado à coinfecção com o vírus H1N1 e leishmaniose visceral. Como a leishmaniose visceral pode imitar doenças hematológicas como HLH, é importante afastar essa condição clínica antes de iniciar a terapia imunossupressora. No caso relatado, o tratamento com anfotericina B lipossomal resultou em uma resolução dramática das anomalias clínicas e laboratoriais.