RESUMO
Hemophagocytic lymphohistiocytosis (HLH) is a rare disorder characterized by extreme immune activation and excessive inflammation. It has been reported in patients with familial cases, immunodeficiencies, malignancies, stem cell transplants, and viral etiologies. This report describes acquired HLH associated with Human herpesvirus-6 (HHV-6) infection in a 76-year-old previously healthy male. The patient was admitted to the hospital due to fever, chills, and abdominal pain. The diagnostic workup revealed gallbladder wall thickening on imaging, concerning for cholecystitis. The patient was started on treatment for sepsis. Further clinical deterioration led to an extensive infectious workup. The patient was found to have elevated soluble IL-2Ra levels, and a bone marrow biopsy was performed, which revealed HLH. A positive HHV-6 polymerase chain reaction in the cerebrospinal fluid and serum confirmed the viral infection. Treatment involved the initiation of high-dose steroids, etoposide, and ganciclovir. Despite these interventions, the patient's clinical status worsened, leading to the implementation of comfort measures, and the patient eventually died. This case underscores the importance of considering HHV-6 as a potential cause of HLH in immunocompetent adults. From this case, we infer that a heightened level of vigilance is necessary to recognize and intervene in this challenging condition promptly.
RESUMO
The objective of present research is to examine the thermal radiation effect in three-dimensional mixed convection flow of viscoelastic fluid. The boundary layer analysis has been discussed for flow by an exponentially stretching surface with convective conditions. The resulting partial differential equations are reduced into a system of nonlinear ordinary differential equations using appropriate transformations. The series solutions are developed through a modern technique known as the homotopy analysis method. The convergent expressions of velocity components and temperature are derived. The solutions obtained are dependent on seven sundry parameters including the viscoelastic parameter, mixed convection parameter, ratio parameter, temperature exponent, Prandtl number, Biot number and radiation parameter. A systematic study is performed to analyze the impacts of these influential parameters on the velocity and temperature, the skin friction coefficients and the local Nusselt number. It is observed that mixed convection parameter in momentum and thermal boundary layers has opposite role. Thermal boundary layer is found to decrease when ratio parameter, Prandtl number and temperature exponent are increased. Local Nusselt number is increasing function of viscoelastic parameter and Biot number. Radiation parameter on the Nusselt number has opposite effects when compared with viscoelastic parameter.
