Human parvovirus B19-induced hemophagocytic lymphohistiocytosis and myocarditis in an adult patient with hereditary spherocytosis

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  • TANAKA Yuka
    Department of Hematology, Saitama Medical Center, Saitama Medical University
  • TAKAHASHI Yasuyuki
    Department of Hematology, Saitama Medical Center, Saitama Medical University
  • KIMURA Yuta
    Department of Hematology, Saitama Medical Center, Saitama Medical University
  • TOMIKAWA Tatsuki
    Department of Hematology, Saitama Medical Center, Saitama Medical University
  • ANAN Tomoe
    Department of Hematology, Saitama Medical Center, Saitama Medical University
  • SAGAWA Morihiko
    Department of Hematology, Saitama Medical Center, Saitama Medical University
  • TABAYASHI Takayuki
    Department of Hematology, Saitama Medical Center, Saitama Medical University
  • WATANABE Reiko
    Department of Hematology, Saitama Medical Center, Saitama Medical University
  • TOKUHIRA Michihide
    Department of Hematology, Saitama Medical Center, Saitama Medical University
  • MOMOSE Shuji
    Department of Pathology, Saitama Medical Center, Saitama Medical University
  • TAMARU Jun-ichi
    Department of Pathology, Saitama Medical Center, Saitama Medical University
  • KIZAKI Masahiro
    Department of Hematology, Saitama Medical Center, Saitama Medical University

Bibliographic Information

Other Title
  • Human parvovirus B19による血球貪食症候群とウイルス性心筋炎を合併した成人の遺伝性球状赤血球症
  • 症例報告 Human parvovirus B19による血球貪食症候群とウイルス性心筋炎を合併した成人の遺伝性球状赤血球症
  • ショウレイ ホウコク Human parvovirus B19 ニ ヨル ケッキュウドンショク ショウコウグン ト ウイルスセイ シンキンエン オ ガッペイ シタ セイジン ノ イデンセイ キュウジョウ セッケッキュウショウ

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Abstract

<p>Human parvovirus B19 (HPV-B19) causes hemophagocytic lymphohistiocytosis (HLH). Here we describe a 35-year-old female with hereditary spherocytosis (HS) who developed HLH due to HPV-B19 infection. Upon admission, she had high fever and diarrhea. Laboratory findings included severe pancytopenia and elevated serum triglyceride and ferritin levels. Moreover, high HPV-B19 levels in the peripheral blood and increased reactive lymphocytosis in the bone marrow led to a diagnosis of HLH due to HPV-B19 infection. With supportive therapy and a blood transfusion, HLH symptoms, including fever and myelosuppression, improved in 1 week. However, symptoms of heart failure (HF) suddenly developed, and an echocardiography revealed diffuse systolic dysfunction, suggesting viral myocarditis due to HPV-B19 infection. Conservative management with diuretics gradually improved HF symptoms over a period of 2 weeks. HPV-B19 infection in adult patients with HS rarely results in severe HLH, but conservative therapy may improve the symptoms. Nonetheless, a careful follow-up is required after HLH improves because viral myocarditis can develop, as was seen in our patient.</p>

Journal

  • Rinsho Ketsueki

    Rinsho Ketsueki 59 (6), 682-687, 2018

    The Japanese Society of Hematology

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