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Case Reports
. 2022 Mar 17;35(3):379-381.
doi: 10.1080/08998280.2022.2039046. eCollection 2022.

Anaplasmosis-induced hemophagocytic lymphohistiocytosis

Mikhail de Jesus  1 , Amanda Lopez  2 , Jevin Yabut  1 , Stephanie Vu  1 , Madhuri Manne  3 , Lauren Ibrahim  4 , Rahul Mutneja  5
Affiliations
Case Reports

Anaplasmosis-induced hemophagocytic lymphohistiocytosis

Mikhail de Jesus et al. Proc (Bayl Univ Med Cent). .

Abstract

Hemophagocytic lymphohistiocytosis (HLH) is a rare, life-threatening inflammatory syndrome of severe immune system activation. It is a diagnostic challenge with high morbidity and mortality. We present a case of HLH due to anaplasmosis infection. A 54-year-old man with chronic obstructive pulmonary disease presented with fever, nausea, vomiting, dyspnea, and arthralgias for 6 days. He had a rapidly progressive clinical decline requiring intubation for acute respiratory failure and dialysis for acute renal failure. He tested positive for anaplasmosis. His workup met criteria for HLH. He was treated with doxycycline and a steroid taper with clinical improvement allowing for extubation and renal recovery. Patients with persistent fevers, hepatosplenomegaly, cytopenias, and hyperferritinemia should be worked up for HLH.

Keywords: Anaplasma; HLH; hemophagocytic; lymphohistiocytosis.

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Figures

Figure 1.
Figure 1.
The trend of ferritin and sCD25 levels after initiation of dexamethasone and doxycycline treatment.
See this image and copyright information in PMC

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