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Childhood tuberculosis presenting with haemophagocytic syndrome

Tarun Verma1, Sameer Aggarwal

  • 1Clinical Haematologist, Command Hospital, Udhampur, J&K India.

Indian Journal of Hematology & Blood Transfusion : an Official Journal of Indian Society of Hematology and Blood Transfusion
|September 3, 2013
PubMed

Insights

Prompt diagnosis and treatment of haemophagocytic syndrome, a severe immune complication of infection, can improve outcomes. This case highlights tuberculosis as a trigger and the effectiveness of combined immunosuppressive and anti-tubercular therapies.

Area of Science:

  • Pediatrics
  • Immunology
  • Infectious Diseases

Background:

  • Haemophagocytic syndrome, a life-threatening complication of systemic infection, arises from an exaggerated immune response.
  • Early recognition and intervention are critical to reduce the high mortality associated with this condition.

Observation:

  • A 2-year-old girl presented with acute enteritis, progressing to prolonged fever, organomegaly, and multi-organ failure.
  • Diagnostic criteria for haemophagocytic lymphohistiocytosis (HLH) were met, including bone marrow evidence of haemophagocytosis.
  • Serological evidence of tuberculosis and a family history of tuberculosis were noted.

Findings:

  • The patient's presentation fulfilled the diagnostic criteria for haemophagocytic lymphohistiocytosis.
  • Co-existing tubercular infection was identified through serological testing and family history.
  • Rapid clinical improvement was observed following initiation of immunosuppressive and anti-tubercular therapies.

Implications:

  • This case underscores the association between tuberculosis and haemophagocytic syndrome.
  • Prompt diagnosis and combined therapeutic strategies (immunosuppressive and anti-tubercular) can lead to favorable outcomes in pediatric HLH.
  • Highlights the importance of considering infectious triggers, such as tuberculosis, in cases of HLH.

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