Open AccessSuper refractory status in a case of Febrile Infection‐Related Epilepsy Syndrome due to hemophagocytic lymphocytic histiocytosis
Author(s) -
MeenakshiSundaram Salvadeeswaran,
Sankaranarayanan Muthukani,
Jeyaraman Murugan,
Ayyappan Chitra,
Karthik Somalinga Nagendran,
Pandi Suresh
Publication year - 2021
Publication title -
epilepsia open
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.247
H-Index - 16
ISSN - 2470-9239
DOI - 10.1002/epi4.12454
Subject(s) - etiology , medicine , status epilepticus , refractory (planetary science) , sepsis , epilepsy , disease , intensive care medicine , pediatrics , histiocytosis , immunology , psychiatry , astrobiology , physics
A 14‐year‐old boy presented with a prodromal respiratory infection followed by super refractory status epilepticus. A diagnosis of Febrile Infection‐Related Epilepsy Syndrome (FIRES) was made. Initial MRI study and CSF analysis were normal. He required multiple anticonvulsants owing to the refractory nature of the seizures. The course of the illness was rather stormy, laced with various medical problems viz. hepatic dysfunction, sepsis, hemodynamic, and hematological abnormalities which posed several challenges in the management. Hemophagocytic lymphocytic histiocytosis (HLH) was identified as the etiology of the illness and was treated but without success. The case report highlights the several immunomodulatory strategies that were employed to treat the disease, despite which the outcome was unfavorable.