Anaplasmosis-induced hemophagocytic lymphohistiocytosis

Mikhail de Jesus; Amanda Lopez; Jevin Yabut; Stephanie Vu; Madhuri Manne; Lauren Ibrahim; Rahul Mutneja

doi:10.1080/08998280.2022.2039046

Anaplasmosis-induced hemophagocytic lymphohistiocytosis

Proc (Bayl Univ Med Cent). 2022 Mar 17;35(3):379-381. doi: 10.1080/08998280.2022.2039046. eCollection 2022.

Authors

Mikhail de Jesus¹, Amanda Lopez², Jevin Yabut¹, Stephanie Vu¹, Madhuri Manne³, Lauren Ibrahim⁴, Rahul Mutneja⁵

Affiliations

¹ Department of Medicine, University of Connecticut, Farmington, Connecticut.
² Frank H. Netter School of Medicine, North Haven, Connecticut.
³ Department of Medicine, St. Francis Hospital, Hartford, Connecticut.
⁴ Department of Infectious Disease, St. Francis Hospital, Hartford, Connecticut.
⁵ Department of Pulmonary and Critical Care Medicine, St. Francis Hospital, Hartford, Connecticut.

Abstract

Hemophagocytic lymphohistiocytosis (HLH) is a rare, life-threatening inflammatory syndrome of severe immune system activation. It is a diagnostic challenge with high morbidity and mortality. We present a case of HLH due to anaplasmosis infection. A 54-year-old man with chronic obstructive pulmonary disease presented with fever, nausea, vomiting, dyspnea, and arthralgias for 6 days. He had a rapidly progressive clinical decline requiring intubation for acute respiratory failure and dialysis for acute renal failure. He tested positive for anaplasmosis. His workup met criteria for HLH. He was treated with doxycycline and a steroid taper with clinical improvement allowing for extubation and renal recovery. Patients with persistent fevers, hepatosplenomegaly, cytopenias, and hyperferritinemia should be worked up for HLH.

Keywords: Anaplasma; HLH; hemophagocytic; lymphohistiocytosis.

Publication types

Case Reports