Premium
A teenage boy with late onset hemophagocytic lymphohistiocytosis with predominant neurologic disease and perforin deficiency
Author(s) -
Beaty Andrew D.,
Weller Christin,
Levy Beth,
Vogler Carole,
Ferguson William S.,
Bicknese Alma,
Knutsen Alan P.
Publication year - 2008
Publication title -
pediatric blood and cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.116
H-Index - 105
eISSN - 1545-5017
pISSN - 1545-5009
DOI - 10.1002/pbc.21438
Subject(s) - hemophagocytic lymphohistiocytosis , hepatosplenomegaly , medicine , perforin , histiocyte , coagulopathy , immunology , hemophagocytosis , macrophage activation syndrome , pediatrics , disease , pathology , pancytopenia , cd8 , immune system , bone marrow
Familial hemophagocytic lymphohistiocytosis (FHLH) is an autosomal recessive disorder of cytotoxic cell function that results in abnormal proliferation of benign lymphocytes and histiocytes in response to infectious stimuli. FHLH generally occurs in very young children, and typically presents with fever, cytopenias, coagulopathy, lymphadenopathy, and hepatosplenomegaly. Central nervous system involvement occurs frequently and may precede the development of systemic symptoms by months to years. We report a case of an 18‐year‐old male with a 2‐year history of symptoms attributed to a demyelinating disorder, who succumbed to rapidly progressive hemophagocyte lymphohistiocytosis. Post‐mortem, two distinct perforin mutations were identified. We discuss the central nervous system and genetic findings in this unusual presentation of familial hemophagocytic lymphohistiocytosis. Pediatr Blood Cancer 2008;50:1070–1072. © 2007 Wiley‐Liss, Inc.