Atypical hemophagocytic lymphohistiocytosis following bacterial tonsillitis in acute lymphoblastic leukemia
Toshio Kakihara1, Chihaya Imai, Takayuki Kaneko
1Department of Homeostatic Regulation and Development, Division of Pediatrics, Niigata University Graduate School of Medical and Dental Sciences, Asahimachi-dori 1, Niigata, 951-8510, Japan. shounika@med.niigata-u.ac.jp
Abstract:
We report a rare case of a cute lymphoblasticleukemia (ALL) who developed dyspnea, neurological disturbance with illusions, pancytopenia, phagocytosis and coagulation disturbances following bacterial tonsillitis. The values of soluble interleukin-2 receptor (sIL-2R), IL-6 and IL-8 were also elevated. Her clinicolaboratory findings were similar to hemophagocytic lymphohistiocytosis (HLH), which is a cytokine disease induced by activated T cells and macrophages. Atypical HLH following bacterial tonsillitis should be kept in mind in leukemia patients.
