Hemophagocytic syndrome in a patient with disseminated tuberculosis: a case report

  • Vania Lombardo | maurizio.soresi@unipa.it Biomedical Department of Internal Medicine and Specialities, University-Hospital of Palermo, Italy.
  • Fania Puccia Biomedical Department of Internal Medicine and Specialities, University-Hospital of Palermo, Italy.
  • Antonino Terranova Biomedical Department of Internal Medicine and Specialities, University-Hospital of Palermo, Italy.
  • Andrea Affronti Biomedical Department of Internal Medicine and Specialities, University-Hospital of Palermo, Italy.
  • Ada Maria Florena Department of Sciences for Health Promotion, Section of Pathology, University-Hospital of Palermo, Italy.
  • Lydia Giannitrapani Biomedical Department of Internal Medicine and Specialities, University-Hospital of Palermo, Italy.
  • Maurizio Soresi Biomedical Department of Internal Medicine and Specialities, University-Hospital of Palermo, Italy.

Abstract

Hemophagocytic syndrome (HS) is a rare disorder of the immune system. It is characterized by fever, lymphadenopathy, hepatosplenomegaly, cytopenia and hyperferritinemia. The cause differs in each country suggesting a specific genetic background and epidemiology of infections, and it can be associated with malignant diseases. A rare cause of HS is tuberculosis (TB), we describe a case of HS associated with disseminated Mycobacterium tuberculosis (MT) infection in a patient from Sudan. He presented diarrhea, fever, pancytopenia, thickened and dilated bowel loops and lymph nodes enlargement at ultrasound and computed tomography scan. A bone marrow biopsy performed to rule out a lymphoma revealed a HS. The bronchoalveolar lavage (BAL) culture was then positive for MT and subsequently, radiologic aspects of lung and spleen TB involvement appeared. A disseminated tuberculosis was diagnosed. Despite antituberculous therapy, the patient died as in approximately 50% of the HS associated with TB.

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Published
2018-03-20
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Section
Case Reports
Keywords:
Hemophagocytic syndrome, hemophagocytic lymphohistiocytosis disseminated tuberculosis, Mycobacterium tuberculosis.
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How to Cite
Lombardo, V., Puccia, F., Terranova, A., Affronti, A., Florena, A. M., Giannitrapani, L., & Soresi, M. (2018). Hemophagocytic syndrome in a patient with disseminated tuberculosis: a case report. Italian Journal of Medicine, 12(1), 61-66. https://doi.org/10.4081/itjm.2018.932