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Case Reports
. 2016 Jul-Sep;19(3):388-91.
doi: 10.4103/0972-2327.165458.

Hemi-meningitis with hemophagocytic lymphohistiocytosis

Ozan Kocak  1 , Coskun Yarar  1 , Sevgi Yimenicioğlu  2 , Arzu Ekici  3 , Özcan Bör  4
Affiliations
Case Reports

Hemi-meningitis with hemophagocytic lymphohistiocytosis

Ozan Kocak et al. Ann Indian Acad Neurol. 2016 Jul-Sep.

Abstract

Hemophagocytic lymphohistiocytosis (HLH) is a rare lymphoproliferative disorder. HLH may occur as a complication of Epstein-Barr virus (EBV), particularly in patients with immunodeficiencies. Herein, we describe a 16-year-old girl with neurological complications associated EBV-induced HLH. Her cerebral magnetic resonance imaging (MRI) showed contrast-enhanced axial T1-weighted images with enhancement of meningeal surface in the right hemisphere that was consistent with right hemi-meningitis. Hydrocephalus, dilated subdural spaces, delayed myelination, edema, diffuse parenchymal atrophy, calcifications, diffuse/patchy white matter abnormalities have all been previously described with HLH. To the best of our knowledge, this is the first case of hemi-meningitis associated with HLH. We suggest that clinicians should consider HLH with vascular disorders when they determine unilateral meningitis on a brain MRI.

Keywords: Epstein-Barr virus; hemi-meningitis; hemophagocytic lymphohistiocytosis; hemophagocytic syndrome.

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Conflict of interest statement

Conflict of Interest: None declared.

Figures

Figure 1
Figure 1
(a, b) Contrast-enhanced axial T1-weighted images showing enhancement of meningeal surface at the right hemisphere. (c) Asymmetrical sulcal involvement seen on the right side on the coronal FLAIR image
Figure 2
Figure 2
Bone marrow evaluation revealed a hypocellular marrow with active hemophagocytosis
See this image and copyright information in PMC

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