Thereafter, haemophagocytosis and infiltration of organs by cytokine-activated histiocytes result in organomegaly, multiorgan dysfunction, life-threatening cytopenias
2) Although the patient in this case had a ferritin level that was highly specific for HLH, he also met 5 out of 8 diagnostic criteria including cytopenia
, fever, hypofibrinoginemia, hemophagocytosis as well as hypofibrinogenemia.
, particularly in the elderly and when accompanied by monocytosis, requires a meticulous history aimed at excluding viral infections and nutritional deprivation.
The clinical presentation of FHL includes primarily fever, hepatomegaly, and cytopenia
, which are the results of functional degradation in cytotoxic T-lymphocytes and natural killer (NK)-cells, activation of macrophages and T-lymphocytes, excessive production of proinflammatory cytokines, and hemophagocytosis (1-3).
1) for their comments on our letter reporting an unusual case of fatal measles without rash in an immunocompetent woman who manifested cytopenias
and an intractable acute respiratory distress syndrome (2).
6,7) The cytopenias
may develop before the diagnosis of Sjogren's syndrome, and sicca symptoms may not be the predominant manifestation.
Adverse events of the haematologic system, including medically significant cytopenia
have been reported with HUMIRA.
Halfdanarson and colleagues (8) reviewed 40 cases of acquired copper deficiency with low hematologic indices, with 22 (55%) of the patients having no other identifiable potential causes for their cytopenia
associated with low dose pulse methotrexate in the treatment of rheumatoid arthritis.
Only a couple of large series reports have described either on its potential to precipitate varying forms of cytopenia
in patients prior to or at the diagnosis of ALL and may infrequently serve as a prodrome to ALL or a persistent B19 infection (9,10).
Most patients present with a history of nonspecific symptoms that reflect a particular cytopenia
The occurrence or progression of hepatosplenomegaly, cytopenia
and marked biochemical parameters such as elevated ferritin, triglycerides, liver enzymes, and biluribin or low fibrinogen should alert the physician to an unusual response for infectious agent (1,2,5,8).
Bone marrow at that time showed mildly hypocellular bone marrow with dyserythropoesis in more than 10% of erythroid precursors and presence of micromegakaryocytes, consistent with refractory cytopenia
according to WHO classification.
A 39-year-old man with AIDS experienced worsening shortness of breath, cytopenia
, and fever and was admitted to Baylor University Medical Center.
A 68-year-old man presented to our hospital with myelodysplasia, a pre-leukaemic haematological disorder characterised by bone marrow malfunction, which leads to cytopenia
of one or more cell lines.