Hodgkin's lymphoma preceded by haemophagocytic lymphohistiocytosis
A 71-year-old woman was admitted because of persistent fever for 2 weeks. A diagnosis of haemophagocytic lymphohistiocytosis (HLH) was made on the basis of persistent high fever, pancytopoenia, hyperferritinaemia, increased soluble interleukin-2 receptor (sIL-2R) levels and histiocytosis and hemopha...
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| creator | Morita, Yoshinori Kenzaka, Tsuneaki Yoshimoto, Hideyuki Ohno, Nobuhito |
| description | A 71-year-old woman was admitted because of persistent fever for 2 weeks. A diagnosis of haemophagocytic lymphohistiocytosis (HLH) was made on the basis of persistent high fever, pancytopoenia, hyperferritinaemia, increased soluble interleukin-2 receptor (sIL-2R) levels and histiocytosis and hemophagocytosis in the bone marrow. CT showed neither infection nor lymphadenopathy. After administration of prednisolone, haematological findings improved and the fever resolved; however, the patient developed persistent fever after 6 months. In addition, levels of lactate dehydrogenase and sIL-2R increased again. CT scans revealed diffuse lymphadenopathy, and Hodgkin's lymphoma was diagnosed by lymph node biopsy. Progression of pancytopenia was observed, and bone marrow examination showed a relapse of HLH. After six courses of chemotherapy were given for Hodgkin's lymphoma, complete remission was achieved with no evidence of pancytopenia. Hodgkin's lymphoma may be the underlying cause in HLH cases of unknown aetiology. Hence, the clinical course should be carefully monitored even in the absence of lymphadenopathy. |
| doi_str_mv | 10.1136/bcr-2013-010129 |
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A diagnosis of haemophagocytic lymphohistiocytosis (HLH) was made on the basis of persistent high fever, pancytopoenia, hyperferritinaemia, increased soluble interleukin-2 receptor (sIL-2R) levels and histiocytosis and hemophagocytosis in the bone marrow. CT showed neither infection nor lymphadenopathy. After administration of prednisolone, haematological findings improved and the fever resolved; however, the patient developed persistent fever after 6 months. In addition, levels of lactate dehydrogenase and sIL-2R increased again. CT scans revealed diffuse lymphadenopathy, and Hodgkin's lymphoma was diagnosed by lymph node biopsy. Progression of pancytopenia was observed, and bone marrow examination showed a relapse of HLH. After six courses of chemotherapy were given for Hodgkin's lymphoma, complete remission was achieved with no evidence of pancytopenia. Hodgkin's lymphoma may be the underlying cause in HLH cases of unknown aetiology. 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A diagnosis of haemophagocytic lymphohistiocytosis (HLH) was made on the basis of persistent high fever, pancytopoenia, hyperferritinaemia, increased soluble interleukin-2 receptor (sIL-2R) levels and histiocytosis and hemophagocytosis in the bone marrow. CT showed neither infection nor lymphadenopathy. After administration of prednisolone, haematological findings improved and the fever resolved; however, the patient developed persistent fever after 6 months. In addition, levels of lactate dehydrogenase and sIL-2R increased again. CT scans revealed diffuse lymphadenopathy, and Hodgkin's lymphoma was diagnosed by lymph node biopsy. Progression of pancytopenia was observed, and bone marrow examination showed a relapse of HLH. After six courses of chemotherapy were given for Hodgkin's lymphoma, complete remission was achieved with no evidence of pancytopenia. Hodgkin's lymphoma may be the underlying cause in HLH cases of unknown aetiology. Hence, the clinical course should be carefully monitored even in the absence of lymphadenopathy.</description><subject>Aged</subject><subject>Antineoplastic Combined Chemotherapy Protocols - therapeutic use</subject><subject>Asia</subject><subject>Biopsy</subject><subject>Bleomycin - therapeutic use</subject><subject>Blood</subject><subject>Bone marrow</subject><subject>Coronary vessels</subject><subject>Cytokines</subject><subject>Dacarbazine - therapeutic use</subject><subject>Dehydrogenases</subject><subject>Doxorubicin - therapeutic use</subject><subject>Epstein-Barr virus</subject><subject>Female</subject><subject>Hemoglobin</subject><subject>Hepatitis</subject><subject>Hodgkin Disease - complications</subject><subject>Hodgkin Disease - drug therapy</subject><subject>Humans</subject><subject>Leukocytes</subject><subject>Lymphatic system</subject><subject>Lymphohistiocytosis, Hemophagocytic - complications</subject><subject>Lymphohistiocytosis, Hemophagocytic - drug therapy</subject><subject>Lymphoma</subject><subject>Other Asian</subject><subject>Prednisolone - therapeutic use</subject><subject>Remission Induction</subject><subject>Spleen</subject><subject>Tomography, X-Ray Computed</subject><subject>Treatment Outcome</subject><subject>Unusual Presentation of More Common Disease/Injury</subject><subject>Veins & arteries</subject><subject>Vinblastine - therapeutic use</subject><issn>1757-790X</issn><issn>1757-790X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNqFkEFLwzAYhoMobsydvUnBgyDUfWnSNr0IOtQJAy8K3kKapGvm2tSkE_rv7egcejKXhOTJ-348CJ1juMGYJLNcujACTELAgKPsCI1xGqdhmsH78a_zCE29X0O_CKaMklM0ikia4BhHY3S_sGr1YeorH2y6qiltJYLGaamVVkHeBaXQlW1KsbKya43cQ6XxrdndWG_8GTopxMbr6X6foLfHh9f5Ily-PD3P75ZhHkOahSJlimKpaFxIraOEZqIgSui4iFROtWS5koSBBFYwzSTGiaAAhdAUp4xmCZmg2yG32eaVVlLXrRMb3jhTCddxKwz_-1Kbkq_sFycpEICsD7jcBzj7udW-5Wu7dXU_M-8rSMRgqJkNlHTWe6eLQwMGvvPOe-98550P3vsfF78HO_A_lnvgegDyav1v2jcc6o1m</recordid><startdate>20130610</startdate><enddate>20130610</enddate><creator>Morita, Yoshinori</creator><creator>Kenzaka, Tsuneaki</creator><creator>Yoshimoto, Hideyuki</creator><creator>Ohno, Nobuhito</creator><general>BMJ Publishing Group LTD</general><general>BMJ Publishing Group</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>5PM</scope></search><sort><creationdate>20130610</creationdate><title>Hodgkin's lymphoma preceded by haemophagocytic lymphohistiocytosis</title><author>Morita, Yoshinori ; Kenzaka, Tsuneaki ; Yoshimoto, Hideyuki ; Ohno, Nobuhito</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b5079-a78d41cd45fcee2649af3dae5f2db4ec8bdc380c08f8e8c116a400fae41784963</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Aged</topic><topic>Antineoplastic Combined Chemotherapy Protocols - therapeutic use</topic><topic>Asia</topic><topic>Biopsy</topic><topic>Bleomycin - therapeutic use</topic><topic>Blood</topic><topic>Bone marrow</topic><topic>Coronary vessels</topic><topic>Cytokines</topic><topic>Dacarbazine - therapeutic use</topic><topic>Dehydrogenases</topic><topic>Doxorubicin - therapeutic use</topic><topic>Epstein-Barr virus</topic><topic>Female</topic><topic>Hemoglobin</topic><topic>Hepatitis</topic><topic>Hodgkin Disease - complications</topic><topic>Hodgkin Disease - drug therapy</topic><topic>Humans</topic><topic>Leukocytes</topic><topic>Lymphatic system</topic><topic>Lymphohistiocytosis, Hemophagocytic - complications</topic><topic>Lymphohistiocytosis, Hemophagocytic - drug therapy</topic><topic>Lymphoma</topic><topic>Other Asian</topic><topic>Prednisolone - therapeutic use</topic><topic>Remission Induction</topic><topic>Spleen</topic><topic>Tomography, X-Ray Computed</topic><topic>Treatment Outcome</topic><topic>Unusual Presentation of More Common Disease/Injury</topic><topic>Veins & arteries</topic><topic>Vinblastine - therapeutic use</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Morita, Yoshinori</creatorcontrib><creatorcontrib>Kenzaka, Tsuneaki</creatorcontrib><creatorcontrib>Yoshimoto, Hideyuki</creatorcontrib><creatorcontrib>Ohno, Nobuhito</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>BMJ case reports</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Morita, Yoshinori</au><au>Kenzaka, Tsuneaki</au><au>Yoshimoto, Hideyuki</au><au>Ohno, Nobuhito</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Hodgkin's lymphoma preceded by haemophagocytic lymphohistiocytosis</atitle><jtitle>BMJ case reports</jtitle><addtitle>BMJ Case Rep</addtitle><date>2013-06-10</date><risdate>2013</risdate><volume>2013</volume><spage>bcr2013010129</spage><pages>bcr2013010129-</pages><issn>1757-790X</issn><eissn>1757-790X</eissn><abstract>A 71-year-old woman was admitted because of persistent fever for 2 weeks. A diagnosis of haemophagocytic lymphohistiocytosis (HLH) was made on the basis of persistent high fever, pancytopoenia, hyperferritinaemia, increased soluble interleukin-2 receptor (sIL-2R) levels and histiocytosis and hemophagocytosis in the bone marrow. CT showed neither infection nor lymphadenopathy. After administration of prednisolone, haematological findings improved and the fever resolved; however, the patient developed persistent fever after 6 months. In addition, levels of lactate dehydrogenase and sIL-2R increased again. CT scans revealed diffuse lymphadenopathy, and Hodgkin's lymphoma was diagnosed by lymph node biopsy. Progression of pancytopenia was observed, and bone marrow examination showed a relapse of HLH. After six courses of chemotherapy were given for Hodgkin's lymphoma, complete remission was achieved with no evidence of pancytopenia. Hodgkin's lymphoma may be the underlying cause in HLH cases of unknown aetiology. Hence, the clinical course should be carefully monitored even in the absence of lymphadenopathy.</abstract><cop>England</cop><pub>BMJ Publishing Group LTD</pub><pmid>23761512</pmid><doi>10.1136/bcr-2013-010129</doi><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; EZB-FREE-00999 freely available EZB journals; PubMed Central |
| subjects | Aged Antineoplastic Combined Chemotherapy Protocols - therapeutic use Asia Biopsy Bleomycin - therapeutic use Blood Bone marrow Coronary vessels Cytokines Dacarbazine - therapeutic use Dehydrogenases Doxorubicin - therapeutic use Epstein-Barr virus Female Hemoglobin Hepatitis Hodgkin Disease - complications Hodgkin Disease - drug therapy Humans Leukocytes Lymphatic system Lymphohistiocytosis, Hemophagocytic - complications Lymphohistiocytosis, Hemophagocytic - drug therapy Lymphoma Other Asian Prednisolone - therapeutic use Remission Induction Spleen Tomography, X-Ray Computed Treatment Outcome Unusual Presentation of More Common Disease/Injury Veins & arteries Vinblastine - therapeutic use |
| title | Hodgkin's lymphoma preceded by haemophagocytic lymphohistiocytosis |
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