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Case Report
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| Dramatic response to HAART in HIV-induced hemophagocytic lymphohistiocytosis | ||||||
| Karan K. Topiwala1, Ellen F. Eaton2, Ricardo A. Franco3 | ||||||
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1Medical Student, Bharati Vidyapeeth Medical College, Pune, Maharashtra, India.
2Fellow, Division of Infectious Disease, University of Alabama, Birmingham, 229 Tinsley Harrison Tower, 1900 University Boulevard, Birmingham, AL, USA. 3MD, Assistant Professor, Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL, USA. | ||||||
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| How to cite this article |
| Topiwala KK, Eaton EF, Franco RA. Dramatic response to HAART in HIV-induced hemophagocytic lymphohistiocytosis. Int J Case Rep Images 2015;6(2):65–69. |
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Abstract
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Introduction:
Hemophagocytic lymphohis-tiocytosis (HLH) is a difficult diagnosis to make and carries with it a high mortality rate, yet it is treatable.
Case Report: We present a 48-year-old African-American male, recently diagnosed with AIDS who had not yet initiated HAART (highly active antiretroviral therapy). He presented with high fever and altered mental status with progressive liver failure and worsening cytopenias. He showed no response to broad spectrum anti-microbial coverage and no infectious etiology could be established. There was no evidence of an opportunist infection or hemophagocytosis (HPC) on a subsequent bone marrow biopsy. In view of his rapid clinical deterioration with multi-organ failure, in the absence of an infectious cause and a stable CD4 cell count, he was diagnosed with HIV induced HLH using the modified-2009 criteria. He was started on HAART and showed a dramatic response with clinical improvement over the next three days, without the need to resort to immunosuppressive agents. The patient was discharged two weeks later, and has remained free of problems over the last eight months. Conclusion: This case report summarizes the importance of an early diagnosis of HIV induced HLH and the importance of early HAART initiation. | |
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Keywords:
Hemophagocytic lymphohistiocytosis (HLH), Hemophagocytosis, Highly active antiretroviral therapy (HAART) Hepatitis B, Herpes simplex virus (HSV), T lymphocytes
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Author Contributions
Karan K. Topiwala – Acquisition of data, Analysis and interpretation of data, Drafting the article, Final approval of the version to be published Ellen F. Eaton – Conception and design, Acquisition of data, Analysis and interpretation of data, Critical revision of the article, Final approval of the version to be published Ricardo A. Franco – Conception and design, Analysis and interpretation of data, Critical revision of the article, Final approval of the version to be published |
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Guarantor of submission
The corresponding author is the guarantor of submission. |
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Source of support
None |
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Conflict of interest
Authors declare no conflict of interest. |
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Copyright
© 2015 Karan K. Topiwala et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information. |
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About The Authors
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