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conferenceseries
.com
Volume 8, Issue 5 (Suppl)
J Blood Disord Transfus, an open access journal
ISSN:2155-9864
Hematology 2017
November 08-09, 2017
November 08-09, 2017 | Las Vegas, USA
11
th
International Conference on
Hematology & Hematological Oncology
Lupus nephritis masquerading as hemophagocytic lymphohistiocytosis
Nova Thomas John
1
, Madhavi Gorusu
1
, Katrina Collins
2
and
Joseph Di Giuseppe
2
1
Starling Physicians, USA
2
Hartford Hospital, Hartford CT, USA
H
emophagocytic Lymphohistiocytosis (HLH) is a rare, life threatening clinical syndrome characterized by hyperinflammatory
cytokine storm due to exaggerated immune response. It may be triggered secondary to infections, malignancies, autoimmune
diseases or medications. The following case report demonstrates acute lupus nephritis with initial presentation as HLH called acute
lupus hemophagocytic syndrome. Estimated prevalence of HLH secondary to Systemic Lupus Erythematosus (SLE) is rare between
0.9-4.6%. A 20-year-old African American female presented with progressive myalgia, malaise and recurrent fevers for 3 weeks.
Vitals signs were normal except for temperature of 102oF. Her examination was unremarkable except for right posterior cervical
lymphadenopathy. Laboratory data showedpancytopenia, hypertriglyceridemia, hyperferritenemia >17,000, hypoalbuminemia. Urine
24-hour protein was elevated >5000 mg/24 hr. Bone marrow biopsy confirmed HLH and Renal biopsy confirmed Lupus nephritis.
With the initiation of immunosuppressive regimen of dexamethasone and mycophenolate mofetil, she improved dramatically with
resolution of fevers and normalization of HLH-specific disease markers. This case highlights the diagnostic challenge that may lead
to delay in diagnosis of acute lupus hemophagocytic syndrome. Patients presenting with unexplained prolonged fever, cytopenia,
abnormal liver function and elevated ferritin levels, should prompt clinicians to perform immunologic testing for SLE in setting of
HLH to avoid diagnostic and therapeutic delays.
Biography
Nova Thomas John has completed her MBBS degree from Kasturba Medical College, Manipal University, Karnataka, India and Internal Medicine residency from University
of Illinois Urbana-Champaign, Illinois, USA. She is currently practicing as a Hospitalist Medicine Physician with Starling Physicians Group, P C at Hartford Hospital, Con-
necticut, USA, since August 2015.
Nova.John@hhchealth.orgNova Thomas John et al., J Blood Disord Transfus 2017, 8:5 (Suppl)
DOI: 10.4172/2155-9864-C1-028