Hemophagocytic Lymphohistiocytosis Possibly Triggered by Craniotomy Surgery: A Rare Association with Uplifting Ending
DOI:
https://doi.org/10.3329/bccj.v11i1.66043Keywords:
Craniotomy Surgery, Hemophagocytic lymphohistiocytosisAbstract
Hemophagocytic lymphohistiocytosis (HLH) is an aggressive and life-threatening syndrome of excessive inflammation
and tissue destruction due to abnormal immune activation. HLH can occur as a familial or sporadic disorder, as well
as can be triggered by a variety of events that disrupt immune homeostasis. In HLH, natural killer cells and cytotoxic
lymphocytes fail to eliminate activated macrophages resulting in excessive CD8+ T cell and activation of more
macrophages with highly elevated levels of interferon-gamma and other cytokines, which drive the pathology of HLH.
Here, we present a case of 15 years old boy with HLH, which possibly was triggered after surgical intervention for
arachnoid cyst in the right parietal lobe. It was a daunting challenge for us to evaluate and diagnose the patient
promptly since he was critically ill and developed pancytopenia, along with grossly altered liver function test and
markedly raised ferritin in a short period of time. But it was even more crucial to start treatment in the form of
chemotherapy in such a patient who had very severe neutropenia as well as thrombocytopenia.
Bangladesh Crit Care J March 2023; 11 (1): 39-42
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