Triple threat: pregnancy, SLE, EBV as potential triggers in secondary hemophagocytic lymphohistiocytosis

Authors

  • Aiswarya Rajendran Department of Medicine, Amrita Institute of Medical Sciences, Kerala, India
  • Akil Adrian Sherif Department of Medicine, Amrita Institute of Medical Sciences, Kerala, India
  • Arun Divakar Department of Medicine, Amrita Institute of Medical Sciences, Kerala, India
  • Sandeep Surendran Department of Medicine, Amrita Institute of Medical Sciences, Kerala, India
  • Jyothi Visalakshy Department of Medicine, Amrita Institute of Medical Sciences, Kerala, India
  • Madhavan Pillai Gopalakrishna Pillai Department of Medicine, Amrita Institute of Medical Sciences, Kerala, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20173603

Keywords:

Hemophagocytic lymphohistiocytosis, Immunological changes in pregnancy, Macrophage activation syndrome

Abstract

We present a case of hemophagocytic lymphocytosis (HLH) that occurred secondary to a combination of Epstein Barr virus (EBV) infection and systemic lupus erythematosus (SLE) in early pregnancy. A 29-years-old lady presented with complaints of fever, vomiting and loose stools. She underwent successful in-vitro fertilization (IVF) and embryo transfer 20 days prior to the onset of these symptoms. Her blood investigations revealed anemia, neutropenia, hyperferritinemia and hypertriglyceridemia, eventually resulting in a diagnosis of HLH further substantiated by bone marrow examination. Additional investigations revealed positive anti-dsDNA and EBV IgM antibodies amongst other findings, adding SLE and EBV to the diagnoses. They were considered potential triggers for HLH. However, the occurrence of these events following IVF poses the question of whether pregnancy played a role in the development of HLH. Our patient responded well to pulse steroid therapy and has had an uneventful course till date.

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Published

2017-07-26

How to Cite

Rajendran, A., Sherif, A. A., Divakar, A., Surendran, S., Visalakshy, J., & Pillai, M. P. G. (2017). Triple threat: pregnancy, SLE, EBV as potential triggers in secondary hemophagocytic lymphohistiocytosis. International Journal of Research in Medical Sciences, 5(8), 3758–3766. https://doi.org/10.18203/2320-6012.ijrms20173603

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Section

Case Reports