Atypical Hemophagocytic Lymphohistiocytosis Following Bacterial Tonsillitis in Acute Lymphoblastic Leukemia

Toshio Kakihara Department of Homeostatic Regulation and Development, Division of Pediatrics, Niigata University Graduate School of Medical and Dental Sciences, Asahimachi-dori 1, 951-8510, Niigata, Japan

Chihaya Imai Department of Homeostatic Regulation and Development, Division of Pediatrics, Niigata University Graduate School of Medical and Dental Sciences, Asahimachi-dori 1, 951-8510, Niigata, Japan

Takayuki Kaneko Department of Homeostatic Regulation and Development, Division of Pediatrics, Niigata University Graduate School of Medical and Dental Sciences, Asahimachi-dori 1, 951-8510, Niigata, Japan

Atsushi Tanaka Department of Homeostatic Regulation and Development, Division of Pediatrics, Niigata University Graduate School of Medical and Dental Sciences, Asahimachi-dori 1, 951-8510, Niigata, Japan

Makoto Uchiyama Department of Homeostatic Regulation and Development, Division of Pediatrics, Niigata University Graduate School of Medical and Dental Sciences, Asahimachi-dori 1, 951-8510, Niigata, JapanCorrespondence[email protected]

Abstract

We report a rare case of acute lymphoblastic leukemia (ALL) who developed dyspnea, neurological disturbance with illusions, pancytopenia, phagocytosis and coagulation disturbances following bacterial tonsillitis. The values of soluble interleukin-2 receptor (sIL-2R), IL-6 and IL-8 were also elevated. Her clinicolaboratory findings were similar to hemophagocytic lymphohistiocytosis (HLH), which is a cytokine disease induced by activated T cells and macrophages. Atypical HLH following bacterial tonsillitis should be kept in mind in leukemia patients.

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Atypical Hemophagocytic Lymphohistiocytosis Following Bacterial Tonsillitis in Acute Lymphoblastic Leukemia

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Atypical Hemophagocytic Lymphohistiocytosis Following Bacterial Tonsillitis in Acute Lymphoblastic Leukemia

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