HHV-8-associated haemophagocytic lymphohistiocytosis in a patient with advanced AIDS

Saroja Bangaru, Amanda Strickland, Dominick Cavuoti, Nainesh Shah

Research output: Contribution to journalArticle

Abstract

We present a patient with advanced AIDS admitted with recurrent shock of unclear aetiology, fevers, altered mental status and refractory cytopenias. His case posed a diagnostic challenge because evaluation of septic shock in the setting of advanced AIDS requires a time-consuming work-up for broad infectious aetiologies that can delay consideration of other diagnoses, including primary or secondary haemophagocytic lymphohistiocytosis (HLH). After this patient did not improve with supportive care and empiric antimicrobials, there was concern for HLH given that he met ≥5 of the HLH consortium criteria. He underwent bone marrow biopsy, which was non-diagnostic. Empiric therapy for HLH was initiated, but unfortunately, the patient died. Autopsy revealed extensive haemophagocytosis in the spleen, bone marrow and liver, confirming the diagnosis of HLH. Postmortem, his soluble CD-25 returned 18 890 pg/mL (<1033 pg/mL), and his serum HHV-8 PCR resulted positive. The diagnosis was HLH secondary to Human Herpes Virus 8 (HHV-8) in a patient with advanced AIDS.

Original languageEnglish (US)
JournalBMJ Case Reports
Volume2017
DOIs
StatePublished - Dec 22 2017

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Keywords

  • haematology (incl blood transfusion)
  • hiv / aids
  • malignant and benign haematology
  • pathology

ASJC Scopus subject areas

  • Medicine(all)

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