Influenza B Virus Triggering Macrophage Activation Syndrome in an Infant

K Jayashree1, Suchetha Rao1, Nutan Kamath1

  • 1Department of Pediatrics, Kasturba Medical College, Manipal University, Mangalore, Karnataka, India.

Insights

Macrophage activation syndrome (MAS), a severe condition, was diagnosed in an infant triggered by influenza B. Prompt treatment with immunoglobulin and steroids led to a positive response.

Area of Science:

  • Pediatrics
  • Immunology
  • Hematology

Background:

  • Macrophage activation syndrome (MAS) is a life-threatening hyperinflammatory condition.
  • MAS results from uncontrolled T-lymphocyte and macrophage activation, leading to multi-organ damage.
  • Key clinical features include fever, hepatosplenomegaly, cytopenias, liver dysfunction, and coagulopathy.

Observation:

  • A 10-month-old infant presented with fever, seizures, and enlarged liver and spleen.
  • Initial laboratory findings included bicytopenia, elevated liver enzymes, and low erythrocyte sedimentation rate.
  • Hyperferritinemia and hypertriglyceridemia were noted, strongly suggesting MAS.

Findings:

  • Influenza B virus infection was identified as the trigger for MAS in this infant.
  • The patient exhibited characteristic laboratory markers of MAS, including significant hyperferritinemia.
  • Successful treatment involved intravenous immunoglobulin and corticosteroid therapy.

Implications:

  • This case highlights influenza B as a potential MAS trigger in infants.
  • Early recognition and prompt treatment with immunotherapy are crucial for MAS management.
  • Understanding MAS pathogenesis is vital for developing targeted therapies in pediatric critical care.

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