Fatal virus‐associated hemophagocytic syndrome associated with coexistent chronic active hepatitis B and acute hepatitis C virus infection

• Published in: American journal of hematology 1999-06, Vol.61 (2), p.135-138
• Main Authors: Faurschou, Mikkel, Nielsen, Ove Juul, Hansen, Per Boye, Juhl, Birgitte Ravn, Hasselbalch, Hans
• Format: Article
• Language: English
• Subjects: Acute Disease; Adult; Biological and medical sciences; Bone Marrow - pathology; Fatal Outcome; Hematologic and hematopoietic diseases; hepatitis B virus; Hepatitis B, Chronic - complications; Hepatitis C - complications; hepatitis C virus; Histiocytosis, Non-Langerhans-Cell - blood; Histiocytosis, Non-Langerhans-Cell - complications; Histiocytosis, Non-Langerhans-Cell - drug therapy; Histiocytosis, Non-Langerhans-Cell - pathology; Humans; Immunosuppressive Agents - therapeutic use; Male; Medical sciences; Other diseases. Hematologic involvement in other diseases; treatment; virus‐associated hemophagocytic syndrome
• ISSN: 0361-8609; 1096-8652
• DOI: 10.1002/(SICI)1096-8652(199906)61:2<135::AID-AJH11>3.0.CO;2-E

A 28‐year‐old man was admitted to our department with intermittent fever, hepatosplenomegaly and pancytopenia. Liver parameters and serum ferritin were markedly elevated. Bone marrow biopsy showed hypocellularity, histiocytic hyperplasia, and hemophagocytosis consistent with a virus‐associated hemophagocytic syndrome (VAHS). There was serological evidence of chronic active hepatitis B and acute hepatitis C virus infection. The patient died despite aggressive immunosuppressive and supportive treatment. Autopsy revealed signs of acute viral hepatitis with cholestasis. Histiocytes engaged in hemophagocytosis were observed in bone marrow and spleen. The condition was interpreted as VAHS associated with chronic active hepatitis B and acute hepatitis C virus infection. To our knowledge this is the first report of a hemophagocytic syndrome in that setting. Am. J. Hematol. 61:135–138, 1999. © 1999 Wiley‐Liss, Inc.