Anzures GSA, Alatoma MNÉ, Reyes GU, Soria SF, Quero HA, Reyes HKL, López CG, Pérez PO, Juárez VR

Language: Spanish
References: 26
Page: 58-62
PDF size: 245.63 Kb.

ABSTRACT

Introduction. Hemophagocytic syndrome is a heterogeneous nosological entity. It is characterized by benign histiocytic proliferation, histologically hemophagocytosis occurs in organs of the nuclear hemophagocytic system. Cases associated with viruses, bacteria and parasites have been reported.
Case report. 5-year-old female preschool, with intermittent fever of one year evolution, she had hepatosplenomegaly, anemia, pancytopenia. Within his study approach, serology showed antibodies for Epstein-Barr: EBC IgM 10 EBNA IgG 47.8 EA IgG 150 VCA IgG 750, as well as hypertriglyceridemia ›2 g/l, hypofibrinogenemia (‹150 mg/dl) and hyperferritinemia (›500ng/ml). Hemophagocytosis in the bone marrow was documented and hemophagocytic syndrome was diagnosed. His management was multidisciplinary.
Conclusión. Hemophagocytic syndrome diagnosis is complex and often late, and can simulate the presence of other infectious diseases. It is important to carry out complementary studies that allow a correct differential diagnosis.

REFERENCES

1. Espinosa, B.K., Garciadiego, F.P. y León, R.E., “Síndromehemofagocítico. Conceptos actuales”, Gac Med Méx, 2013, 149: 431-437.

2. Sen, E.S., Steward, C.G. y Ramanan, A.V., “Diagnosinghaemophagocytic syndrome”, Arch Dis Child, 2017, 102(3): 279-284.

3. Bautista, E.K.A., Fossas, G.P. y Rodríguez, L.E.. “Síndromehemofagocítico. Conceptos actuales”, Gac MedMéx, 2013, 149: 431-437.

4. Díaz, D.J., Díaz, H.C., Bastida, V.P., Llort, S.A., Elorza, A.,Olive, O.T. y Sánchez, T.J., “Síndrome hemofagocítico:expresión de diversas entidades nosológicas”, An Pediatr(Barcelona), 2009, 71 (2): 110-116.

5. Astigarraga, L.I., González, G.L. y Alsina, A.L., “Síndromeshemofagocíticos: la importancia del diagnóstico ytratamiento precoces”, An Pediatr (Barcelona), 2018, 89(2): 124.e1-124.e8.

6. Herrero, H.S., Ramírez, J.F., García, M.A. y Valverde, M.,“Síndromes hemofagocíticos”, An Esp Pediatr, 1998,49: 230-236.

7. Luna, M.C., Del Águila, Á.O., Estupiñán, V.M. y Mattos,V.E., “Síndrome hemofagocítico o linfohistiocitosis hemofagocíticapor virus Epstein-Barr. Reporte de caso”,Rev Fac Med Hum, 2016, 16 (2): 81-84.

8. Freeman, H.R. y Ramanan, A.V., “Review of haemophagocyticlymphohistiocytosis”, Arch Dis Child, 2011, 96(7): 688-693.

9. Maakaroun, N.R., Moanna, A., Jacob, J.T. y Albrecht, H.,“Viral infections associated with haemophagocytic syndrome”,Rev Med Virol, 2010, 20 (2): 93-105.

10. Sandoval, R.E., Camacho, M.I., Eduardo, S.N., Plascencia,T.O. et al., “Síndrome hemofagocítico asociado conhepatitis”, Rev Alerg Mex, 2016, 63 (1): 91-94.

11. Shamriz, O., Kumar, D., Shim, J., Briones, M., Quarmyne,M.O., Chonat, S. et al., “La linfohistiocitosis hemofagocíticaasociada al virus de las células t-Epstein-Barr(hlh) se produce en no asiáticos y se asocia con un estadode activación de células t que es comparable a lahlh primaria”, J Clin Immunol, 2021, 41 (7): 1582-1596.

12. Contreras, C.P., Anampa, G.A., Gaznabi, S. y Lansigan,F., “Epstein-Barr virus infection-associated hemophagocyticlymphohistiocytosis”, Cureus, 2020, 12 (4): e7563.

13. Fałkowska, A., Prądzyńska, K. y Drabko, K., “Difficultbalance between ebv treatment and posttransplantimmunosuppression: a successful transplant in a childwith recurrent Epstein-Barr virus-induced hemophagocyticlymphohistiocytosis”, Transplant Proc, 2021, 53 (6):2035-2039.

14. Astudillo, P.P., Parejas, T.C., Wietstruck, P.M., Morales,M.P. y Abarca, V.K., “Síndrome hemofagocítico: caracterizaciónclínica y seguimiento de una cohorte pediátricachilena”, Rev Chilena Infectol, 2021, 38 (3): 423-431.

15. Mărginean, M.O., Molnar, E. y Chinceşan, M.I., “Epstein-Barr virus-associated hemophagocytic lymphohistiocytosisin a small child: a case report”, Medicine(Baltimore), 2020, 99 (3): e18759.

16. Wass, M., Bauer, M., Pfannes, R., Lorenz, K., Odparlik,A., Müller, L.P. y Wickenhauser, C., “Chronic active Epstein-Barr virus infection of t-cell type, systemic form inan African migrant: case report and review of the literatureon diagnostics standards and therapeutic options”,bmc Cancer, 2018, 18 (1): 941.

17. Canna, S.W. y Marsh, R.A., “Pediatric hemophagocyticlymphohistiocytosis”, Blood, 2020, 135 (16): 1332-1343.

18. La Cruz, A.D., Povea, P.J.C., Javier, N.R., Altamirano,M.M. y Abarca, S.S., “Tratamiento exitoso de síndromehemofagocítico secundario a infección por virus deEpstein-Barr: reporte de caso”, Acta Médica Peruana,2019, 36 (3), 227-230.

19. García, P.M., Jiménez, C.M.I., Mañes, J.Y., Pariente,M.M., González, G.D. y Calvo, R.F., “Primoinfección porel virus de Epstein-Barr en niños sanos”, An Pediatr (Inglaterra), 2019, 90 (6): 376-385.

20. Kim, H.J., Ko, Y.H., Kim, J.E., Lee, S.S., Lee, H., Park,G. et al., “Hematopathology Study Group of the KoreanSociety of Pathologists. Epstein-Barr virus-associatedlymphoproliferative disorders: review and update on2016 who classification”, J Pathol Transl Med, 2017, 51(4): 352-358.

21. Cleves, D., Lotero, V., Medina, D., Pérez, P.M., Patiño,J.A. y Torres, C.L., “Pediatric hemophagocytic lymphohistiocytosis:a rarely diagnosed entity in a developingcountry”, bmc Pediatr, 2021, 21 (1): 411.

22. Pérez, A., “Síndrome hemofagocítico”, An PediatricContin, 2013, 11 (5): 245-253.

23. Reyes, H.K.L., Santos, C.L., Reyes, G.U., Quero, H.A.,López, C.G., Reyes, H.D.P. et al., “Síndrome linfohistiocíticohemofagocítico secundario a infección urinaria porEscherichia coli, reporte de caso”, Enf Infec Microbiol,2019, 39 (1): 36-42.

24. Marsh, R.A., “Virus de Epstein-Barr y linfocitosis hemofagocítica”,Inmunol, 2018, 8: 1902.

25. Huang, P., Huang, C., Xu, H., Lu, J., Tian, R., Wang, Z. yChen, Y., “Early use of blood purification in severe Epstein-Barr virus-associated hemophagocytic syndrome”,Pediatrics, 2020, 145 (6): e20193197.

26. Uribe-Franco, R.C., Milán-Salvatierra, A.I. y Román-Bahena,D.A, “Síndrome hemofagocítico secundario”, RevHematol Mex, 2021, 22 (3): 189-196.