RT Journal Article
SR Electronic
T1 Hemophagocytic lymphohistiocytosis: a rare association with pulmonary cryptococcosis
JF BMJ Case Reports
JO BMJ Case Reports
FD BMJ Publishing Group Ltd
SP e230255
DO 10.1136/bcr-2019-230255
VO 12
IS 8
A1 Pawan Kumar Singh
A1 Rakesh Kodati
A1 Manish Rohilla
A1 Prashant Sharma
YR 2019
UL http://casereports.bmj.com/content/12/8/e230255.abstract
AB Hemophagocytic lymphohistiocytosis (HLH) is an inflammatory syndrome characterised by unregulated macrophage and T-lymphocyte activation, resulting in cytokine overproduction and subsequent histiocytic phagocytosis. Here we report a case of pulmonary cryptococcosis, in a 59-year-old diabetic patient, with no other risk factors whose clinical course was complicated by secondary hemophagocytosis. Even after addressing the primary underlying illness (pulmonary cryptococcosis), his clinical condition continued to worsen. After excluding the other causes of HLH and possible reasons of his clinical worsening, glucocorticoids were added following which the patient experienced a remarkable improvement in his clinical and laboratory parameters. To our knowledge, this is the first case report of HLH being caused by pulmonary cryptococcosis and only second case report of cryptococcosis being complicated with HLH (previous report being associated with meningoencephalitic cryptococcosis).