A case of pulmonary tuberculosis diagnosed in a patient with manifestations of haemophagocytic lymphohistiocytosis. Issue 3 (29th March 2019)

• Record Type: Journal Article
• Authors: Ohata, Shinya; Hara, Kenta; Arai, Takashi; Takayoshi, Tomofumi; Nishiyama, Katsuhito; Yasutomo, Yoshiro; Yokono, Koichi; Sugimoto, Takeshi
• Is Part Of: Oxford medical case reports. Volume 2019:Issue 3(2019)
• Publication Date: 2019-03-29
• Subjects: Clinical medicine -- Case studies -- Periodicals; 616.09
• DOI: 10.1093/omcr/omz013
• Languages: English
• ISSNs: 2053-8855

Abstract

Abstract: An 80-year-old woman was admitted with continuous fever, hepatic dysfunction and cytopaenia. The presence of hepatosplenomegaly, hyperferritinaemia, hypofibrinogenaemia and phagocytosis by macrophages in the bone marrow was consistent with a diagnosis of haemophagocytic lymphohistiocytosis (HLH). We suspected that HLH was induced by pre-existing tuberculosis, and antitubercular agents were started. Positive nucleic acid amplification and sputum culture for Mycobacterium tuberculosis resulted in a diagnosis of pulmonary tuberculosis. The patient improved with three months of treatment. In this patient, manifestations of HLH preceded those of pulmonary tuberculosis. A diagnosis of HLH should increase suspicion of disseminated tuberculosis and thus contribute to early detection.