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Guillain-Barrésyndrome and hemophagocytic syndrome heralding the diagnosis of diffuse large B cell lymphoma:A case report

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World Journal of Clinical Cases 2022年第26期10卷 9502-9509页

作者： Qiao-Lin Zhou Zhao-Kun Li Fang Xu Xiao-Gong Liang Xing-Biao Wang Jing Su Yu-Feng Tang Department of Hematology Mianyang Central HospitalSchool of MedicineUniversity of Electronic Science and Technology of ChinaMianyang 621000Sichuan ProvinceChina Department of Neurology Mianyang Central HospitalSchool of MedicineUniversity of Electronic Science and Technology of ChinaMianyang 621000Sichuan ProvinceChina Department of General Surgery Mianyang Central HospitalSchool of MedicineUniversity of Electronic Science and Technology of ChinaMianyang 621000Sichuan ProvinceChina

BACKGROUND Central nervous system(CNS)lesions and peripheral neuropathy are rare among patients with non-Hodgkin’s lymphoma(NHL).Lymphomatous infiltration or local oppression usually accounts for CNS or peripheral nerve *** incidence of peripheral neuropathy was 5%.Guillain-Barrésyndrome(GBS)is rare and may occur in less than 0.3%of patients with *** syndrome(HPS)is a rare complication of *** has been reported that 1%of patients with hematological malignancies develop *** large B-cell lymphoma(DLBCL)combined with GBS has been reported in 10 *** SUMMARY We report the case of a 53-year-old man who was initially hospitalized because of abnormal feelings in the lower limbs and urinary *** was finally diagnosed with DLBCL combined with GBS and HPS after 16 d,which was earlier than previously *** pulse therapy,dexamethasone,and etoposide were immediately *** neurological symptoms did not improve,but cytopenia was ***,GBS-related clinical symptoms were relieved partially after one cycle of rituximab-cyclophosphamide,hydroxydaunorubicin,vincristine,and prednisone(R-CHOP)chemotherapy and disappeared after six cycles of *** GBS and HPS heralding the diagnosis of Epstein-Barr virus DLBCL are ***,we report a rare case of DLBCL combined with GBS and HPS,and share our clinical *** therapies may be effective if GBS occurs before lymphoma is *** diagnosis and treatment of DLBCL are crucial.

关键词： Diffuse large B cell lymphoma Guillain-Barrésyndrome hemophagocytic syndrome Peripheral neuropathy Case report

Diagnostic value of bone marrow cell morphology in visceral leishmaniasis-associated hemophagocytic syndrome:Two case reports

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World Journal of Clinical Cases 2022年第16期10卷 5463-5469页

作者： Shu-Lan Shi Heng Zhao Beng-Jiang Zhou Ming-Biao Ma Xiao-Juan Li Ji Xu Hong-Chao Jiang Clinical Laboratory The Kunming Children's HospitalKunming 650228Yunnan ProvinceChina Department of Viro-immunology Institute of Medical Biology Chinese Academy of Medical SciencesKunming 650118Yunnan ProvinceChina Department of Parasitology Kunming Medical University Haiyuan CollegeKunming 650031Yunnan ProvinceChina Yunnan Key Laboratory of Children's Major Disease Research The Kunming Children's HospitalKunming 650228Yunnan ProvinceChina

BACKGROUND Visceral leishmaniasis related-hemophagocytic lymphohistiocytosis(VL-HLH)is a hemophagocytic syndrome caused by Leishmania ***-HLH is rare,especially in nonendemic areas where the disease is severe,and mortality rates are *** key to diagnosing VL-HLH is to find the pathogen;therefore,the Leishmania must be accurately identified for timely clinical *** SUMMARY We retrospectively analyzed the clinical data,laboratory examination results,and bone marrow cell morphology of two children with VL-HLH diagnosed via bone marrow cell morphology at Kunming Children’s Hospital of Yunnan,*** cases suspected of having malignant tumors at other hospitals and who were unresponsive to treatment were transferred to Kunming Children’s *** are Han Chinese girls,one was 2 years old and the other one is 9 mo *** had repeated fevers,pancytopenia,hepatosplenomegaly,hypertriglyceridemia,and hypofibrinogenemia over a long period and met the HLH-2004 *** HLH genetic test results were *** children underwent chemotherapy as per the HLH-2004 chemotherapy regimen,but it was ineffective and accompanied by serious *** found Leishmania amastigotes in their bone marrow via morphological examination of their bone marrow cells,which showed hemophagocytic cells;thus,the children were diagnosed with *** being transferred to a specialty hospital for treatment,the condition was *** Morphological examination of bone marrow cells plays an important role in diagnosing *** clinically diagnosing secondary HLH,VL-HLH should be considered in addition to common pathogens,especially in patients for whom HLH-2004 chemotherapy regimens are *** infants and young children,bone marrow cytology examinations should be performed several times and as early as possible to find the pathogens to reduce potential misdiagnoses.

关键词： Bone marrow cell morphology Visceral leishmaniasis hemophagocytic syndrome Infant Case report

Clinical and Biological Significance of Clonal Macrophage Detection in hemophagocytic syndrome

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Journal of Huazhong University of Science and Technology(Medical Sciences) 2002年第2期22卷 126-128页

作者： LIN Wen(林雯) XIAO Yan(肖燕) FEI Hongbao(费洪宝) Department of Pediatrics X iehe Hospital Tongji Medical College Huazhong University of Science and TechnologyWuhan 430022 Department of Pediatrics X iehe Hospital Tongji Medical College Huazhong University of Science and TechnologyWuhan 430022 Department of Pediatrics X iehe Hospital Tongji Medical College Huazhong University of Science and TechnologyWuhan 430022

Summary: By using the method of clonal analysis the evidence to prove that hemophagocytic syndrome (HPS) is reactive or malignant was investigated to probe into the pathogenesis of HPS and its relations with clinical prognosis. The macrophages abnormally proliferated in bone marrow were isolated. Electrophoresis analysis was made after DNA extraction, enzyme restriction of human ardrogen receptor (HUMARA) genetic locus, and PCR amplification. In the 9 specimens, clonal proliferation was found in 2 cases and nonclonal proliferation in 7. Among the 7 cases of nonclonal proliferation, 3 were voluntarily discharged without clinical outcome, 2 cases fully recovered after 2-3 week treatment of large dose gamma globulin intravenous drip and hormone therapy, 1 case died at the 43th day after the hormone and anti-infection therapy, and one case was found to have granular leukoblast in peripheral blood after 3 weeks and diagnosed as having M2a after bone puncture. For the two patients with clonal proliferation, one obtained remission after chemotherapy and the other was died after 32 days without chemotherapy. It was concluded that there do exist clonal or malignant proliferation in HPS, so not every case is reactive.

关键词： hemophagocytic syndrome clone chemotherapy

“Typhoidal Cells”Appear in a Woman with hemophagocytic syndrome Secondary To Brucellosis:A Case Report

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Chinese Medical Sciences Journal 2023年第1期38卷 62-65页

作者： Wei-Qing Song Xu Zheng Hai-Ni Li Li Li Jiang-Shui Yuan Shu-Guo Wang Clinical Laboratory Qingdao HospitalUniversity of Health and Rehabilitation Sciences(Qingdao Municipal Hospital)Qingdao 266011ShandongChina Department of Gastroenterology Qingdao Sixth People’s HospitalQingdao 266001ShandongChina

We report a case of hemophagocytic syndrome(HPS)secondary to brucellosis,in which typhoidal cells were found in bone marrow,suggesting typhoidal cells present not only in Salmonella typhi infections but also in other bacterial *** cells in bone marrow can be used to quickly identify the presence of bacterial infection pending the results of bone marrow and/or blood cultures.

关键词： brucellosis hemophagocytic syndrome typhoidal cells

Kikuchi-Fujimoto Disease with hemophagocytic syndrome and Pleural Effusion in an Elder Man: A Case Report and Literature Review

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Case Reports in Clinical Medicine 2020年第10期9卷 311-318页

作者： Yanfang Zhang Jianchuan Deng Department of Hematology The Second Affiliated Hospital of Chongqing Medical University Chongqing China

Background: Kikuchi-Fujimoto disease (KFD), also named Histiocytic necrotizing lymphadenitis (HNL), is a rare and self-limited necrotizing lymphadenitis, most commonly affects young Asian female. KFD is characterized by lymphadenopathy, cytopenia, fever, rashes, and weight loss, however, hemophagocytic syndrome and pleural effusion are rarely reported. Case Presentation: We present the case of a 61-year-old man with clinical features including fever, lymphadenopathy, purpura, arthralgia, pleural effusion and pulmonary infection. He had cervical lymphnodebiopsy and the pathology is consistent with KFD, laboratory tests and clinical manifestations were consistent with hemophagocytic syndrome (HLH). After initial treatment including corticosteroid and anti-infection drugs, the patient showed improvement but soon deteriorated. Conclusion: KFD is a self-limited disease with spontaneous resolution. However, the cases of KFD with HLH may have a fatal course. Early appropriate intensive immunosuppressive therapy and strong anti-infection therapy could be beneficial for the treatment outcome.

关键词： Kikuchi-Fujimoto Disease hemophagocytic syndrome Pleural Effusion

Toxoplasmosis-Associated Secondary hemophagocytic syndrome: A Case Report and Literature Review

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Open Journal of Blood Diseases 2020年第3期10卷 61-70页

作者： Xiang Sun Jiakui Zhang Qianling Ye Fan Wu Yinwei Li Qianshan Tao Qing Zhang Weiwei Zhu Huiping Wang Jinli Zhu Zhimin Zhai Department of Hematology Hamatological Research Center The Second Affiliated Hospital of Anhui Medical University Hefei China

Background: Toxoplasmosis is an extremely rare disease that occurs in the hosts contact with cat and dog frequently. Most human acute infections go unnoticed in immunocompetent individuals, and gradually transformed into chronic infection. However, while host immunity significantly waned, the risk of reactivation of chronic toxoplasma infection is greatly increased. Reactivation of latent toxoplasmic infection often presents with fever, leukopenia, thrombocytopenia, neurological signs and pneumonia. However, for the non-specific clinical and biological signs and its fetal outcome, toxoplasmosis is often misdiagnosed and only revealed at autopsy. Case Presenation: We report a case hospitalized for a week history of cough, anorexia and fatigue with nasal bleeding for a day. After hospitalization, broad-spectrum antibiotherapy was started without a clear diagnosis of infection. Then the patient did a lot of investigations to search the cause of infection, but there were no positive findings. However, an unexpected discovery was detected from peripheral blood smears, shows 1 - 3 μm in diameter, scattered, short and bow lik

关键词： Toxoplasmosis Infection Reactivation hemophagocytic syndrome

Unexpected Occurrence of Fetal hemophagocytic syndrome in a Patient with Hereditary Diffuse Leukoencephalopathy with Spheroids

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Case Reports in Clinical Medicine 2016年第3期5卷 77-84页

作者： Yasufumi Kondo Michiaki Kinoshita Takuhiro Yoshida Hisanori Matoba Takeshi Uehara Meguru Ikeyama Jun Nakayama Kunihiro Yoshida Shu-Ichi Ikeda Department of Medicine (Neurology & Rheumatology) Shinshu University School of Medicine Matsumoto Japan Department of Neurology Komoro Kosei General Hospital Komoro Japan Department of Neurology Suwa Red Cross Hospital Suwa Japan Department of Neurology Ina Central Hospital Ina Japan Department of Laboratory Medicine Shinshu University School of Medicine Matsumoto Japan Department of Molecular Pathology Shinshu University Graduate School of Medicine Matsumoto Japan Department of Brain Disease Research Shinshu University School of Medicine Matsumoto Japan

Colony stimulating factor-1 receptor (CSF1R) plays important roles in the differentiation and proliferation of macrophage and microglia in systemic organs and the brain. A genetic defect in CSF1R causes hereditary diffuse leukoencephalopathy with spheroids (HDLS). HDLS mainly affects the cerebral white matter and shows pre-senile cognitive decline, motor disturbance, and epilepsy. However, systemic manifestations outside the brain have not yet been described in patients with HDLS. Here, we report the case of a 41-year-old man with HDLS carrying the p. K793T mutation in CSF1R, who unexpectedly died of sepsis and hemophagocytic syndrome shortly after the onset of HDLS. The fetal sequence of sepsis and hemophagocytic syndrome was triggered by enterocolitis. An autopsy revealed that focal inflammation in the intestine had almost resolved. Most strikingly, massive infiltration of cluster of differentiation (CD) 68- and CD163-immunopositive macrophages with hemophagocytosis was observed in the bone marrow, spleen, and liver. Less abundant infiltration of CD68- and CD204-immunopositive macrophages without hemophagocytosis was also seen in the lung and intestine. At present, the pathogenetic link between CSF1R mutation and hemophagocytic syndrome in this patient is unclear. Our case, however, clearly shows that even in patients with HDLS, aberrant activation of functional macrophages can be induced under certain conditions in visceral organs.

关键词： HDLS (Hereditary Diffuse Leukoencephalopathy with Spheroids) CSF1R (Colony Stimulating Factor-1 Receptor) Enterocolitis Macrophage hemophagocytic syndrome

One hemophagocytic syndrome Relating to Adult Epstein-Barr Virus Infection and a Literature Review

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Case Reports in Clinical Medicine 2016年第12期5卷 511-517页

作者： Xiaolong Liu Yamin Zhang Zilin Cui Qing Tian Dongming Duan Department of Hepatobiliary Surgery Tianjin First Central Hospital Tianjin China

Background: Adult hemophagocytic syndrome is a critical condition that is often difficult to diagnose and results in a bad prognosis because of the lack of effective and unified treatment. Aim: To investigate the clinical, diagnosis and treatment of hemophagocytic syndrome. Case Presentation: A 22-year-old female patient received a splenectomy, and the spleen was sent to the King Med Center of Medical Inspection. The results confirmed the diagnosis of hemophagocytic syndrome related to EB (Epstein-Barr) virus infection. Conclusion: Early diagnosis and early intervention are important factors for affecting the progression of the disease and improving its prognosis.

关键词： hemophagocytic syndrome Epstein-Barr Viru Diagnosis Treatment

Acute Kidney Injury with Epstein Barr Virus-Associated hemophagocytic syndrome

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Case Reports in Clinical Medicine 2016年第7期5卷 233-237页

作者： Ryo Ishida Kazumi Komaki Tetsuro Kusaba Tsuneyuki Nakanouchi Japanese Red Cross Kyoto Daiichi Hospital Kyoto Japan Division of Nephrology Department of Medicine Kyoto Prefecture University of Medicine Kyoto Japan

A 59-year-old man, who was treated for schizophrenia and psoriasis vulgaris with risperidone and cyclosporine, presented with high fever and myalgia. Those did not respond to treatment for neuroleptic malignant syndrome for two weeks, and multiple organ dysfunction developed, so he was admitted to our hospital, but died two days later. Autopsy detected the hemophagocytosis, Epstein Barr Virus (EBV)-reactivated cells, and the absence of glomerulonephritis and interstitial tubulitis. We considered that hemophagocytic syndrome (HPS) and myalgia were caused by reactivated EBV and the viremia under immunosuppression, and renal failure was caused by sepsis-like state by cytokine storm of HPS.

关键词： hemophagocytic syndrome Epstein Barr Virus Acute Kidney Injury