Hemophagocytic Lymphohistiocytosis in a Patient with Adult-Onset Still’s Disease – a Diagnostic Dilemma

International Journal of Medical Science
© 2017 by SSRG - IJMS Journal
Volume 4 Issue 4
Year of Publication : 2017
Authors : Priyank Gupta, Roopesh Pandey and Chetan Unadkat
pdf
How to Cite?

Priyank Gupta, Roopesh Pandey and Chetan Unadkat, "Hemophagocytic Lymphohistiocytosis in a Patient with Adult-Onset Still’s Disease – a Diagnostic Dilemma," SSRG International Journal of Medical Science, vol. 4,  no. 4, pp. 8-10, 2017. Crossref, https://doi.org/10.14445/23939117/IJMS-V4I4P103

Abstract:

Hemophagocytic lymphohistiocytosis (HLH) is a serious complication of Adult-onset Still’s Disease(AOSD) and because of their overlapping clinical features, there will be delay in the diagnosis leading to increased morbidity and mortality. Here we present a case report of 61 years old female patient who were diagnosed with AOSD associated with secondary HLH, which despite treatment, led to fatal outcome.

Keywords:

  Hemophagocytic lymphohistiocytosis, Adult-onset Still’s Disease, Ferritin.

References:

[1] Bella Mehta and Petros Efthimiou. Ferritin in Adult-Onset Still’s Disease: Just a Useful Innocent Bystander? International Journal of Inflammation; Volume 2012
[2] Ohta A, Yamaguchi M, Kaneoka H, Nagayoshi T, Hiida M. Adult Still’s disease: review of 228 cases from the literature. J Rheumatol 1987; 14: 1139-46.
[3] Coffernils M, Soupart A, Pradier O, Feremans W, Neve P, Decaux G. Hyperferritinemia in adult onset Still’s disease and the hemophagocystic syndrome. J Rheumatol 1992; 19: 1425-7.
[4] Kumakura S, Ishikura H, Munemasa S, Adachi T, Murakawa Y, Kobayashi S. Adult onset Still’s disease associated hemophagocytosis. J Rheumatol 1997; 24: 1645-8.
[5] Takeshita A, Takeuchi T, Nakagawa A, Tsuda Y, Fukuda A, Nariyama K, Shibayama Y. Adult onset Still’s disease with hemophagocytic syndrome and severe liver dysfunction. Hepatol Res 2000; 17: 139-44.
[6] Piyush Ranjan, Sanchit Sharma, Hara Prasad Pati, Naval K Vikram, Rita Sood.  Hemophagocytic Lymphohistiocytosis Complicating the Clinical Presentation of Adult-Onset Still’s Disease. IJHSR Vol.6; Issue: 3; March 2016
[7] Janka GE. Familial and acquired hemophagocytic lymphohistiocyto-sis. Eur J Pediatr 2007; 166:95-109. 
[8] Yamaguchi M, Ohta A, Tsunematsu T, Kasukawa R, Mizushima Y, Kashiwagi H, et al. Preliminary criteria for classification of adult Still’s disease. J Rheumatol 1992; 19:424–30. 
[9] Arlet J, Le T, Marinho A, Amoura Z, Wechsler B, Papo T, et al. Reactive haemophagocytic syndrome in adult-onset Still’s disease: a report of six patients and a review of the literature. Ann Rheum Dis. 2006; 65:1596–601.
[10] Yalkın Çalik, Safinaz Ataoğlu, Ersun Baş, Selma Yazici, Ali Erdem Baki, Metin Yavuz. Hemophagocytic Syndrome In A Patient With Adult-Onset Still’s Disease. Turk J Rheumatol 2011;26(2):150-153
[11] Emmenegger U, Reimers A, Frey U, Fux Ch, Bihl F, Semela D, et al. Reactive macrophage activation syndrome: a simple screening strategy and its potential in early treatment initiation. Swiss Med Wkly 2002;132:230-6.
[12] Maeshima K, Ishii K, Iwakura M, et al. Adult onset Still’s disease with macrophage activation syndrome successfully treated with a combination of  methotrexate and etanercept. Mod Rheumatol. 2011.
[14] Chang-Bum Bae, Ju-Yang Jung, Hyoun-Ah Kim, Chang-Hee Suh. Reactive Hemophagocytic Syndrome in Adult-Onset Still Disease. Clinical Features, Predictive Factors, and Prognosis in 21 Patients. Medicine; Volume 94, Number 4, January 2015
[15] Robin Dhote,  Jeanne Simon, et.al. Reactive Hemophagocytic Syndrome In Adult Systemic Disease: Report Of Twenty-Six Cases And Literature Review. Arthritis & Rheumatism (Arthritis Care & Research) Vol. 49, No. 5, October 15, 2003, p 633–639