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Hemophagocytic lymphohistiocytosis caused by systemic herpes simplex virus type 1 infection: Successful treatment with dexamethasone palmitate
Author(s) -
Otsubo Keisuke,
Fukumura Akiko,
Hirayama Mariko,
Morimoto Tsuyoshi,
Kato Masahiko,
Mochizuki Hiroyuki
Publication year - 2016
Publication title -
pediatrics international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.49
H-Index - 63
eISSN - 1442-200X
pISSN - 1328-8067
DOI - 10.1111/ped.12817
Subject(s) - medicine , dexamethasone , prednisolone , herpes simplex virus , hemophagocytic lymphohistiocytosis , disseminated intravascular coagulation , immunology , gastroenterology , virus , disease
Hemophagocytic lymphohistiocytosis (HLH) is a hyperinflammatory condition resulting from an uncontrolled and ineffective immune response. Here, we report a case of HLH caused by disseminated herpes simplex virus (HSV)‐1 infection. The patient was initially treated with prednisolone and high‐dose acyclovir. Although liver enzymes, coagulation abnormalities, and inflammatory markers were remarkably improved, the platelet count remained low. Prednisolone was therefore switched to dexamethasone palmitate. Thereafter, the platelet count normalized. Inflammatory markers normalized 30 days after admission and serum HSV‐DNA became undetectable on day 41. The patient was discharged on day 91 and no developmental delay was evident at 7 months of age. These findings suggest that dexamethasone palmitate is effective for neonatal HLH.