Multiple organ failure and severe bone marrow dysfunction in two 18 year-old Caucasian patients: Epstein-Barr virus and the haemophagocytic syndrome.

Abstract:

:Haemophagocytic lymphohistiocytosis secondary to viral infection is an unusual but well recognised cause of bone marrow dysfunction and multiple organ failure in young patients. Two 18 year-old patients were admitted to a tertiary liver unit with features of acute liver failure, cardio-respiratory collapse and pancytopenia. Serological tests and bone marrow examination with in-situ hybridisation revealed severe acquired haemophagocytic lymphohistiocytosis secondary to acute Epstein-Barr virus infection. Both patients died despite full supportive therapy; the first due to pulmonary haemorrhage, the second due to acute respiratory distress syndrome refractory to high frequency oscillatory ventilation. The clinical spectrum, diagnostic features and current evidence based recommendations for treatment of this condition are explored. The diagnosis of haemophagocytic lymphohistiocytosis should be considered in young patients with marked bone marrow dysfunction and multiple organ failure. Further research into appropriate therapy for patients with acute severe forms of the disease who require intensive organ support is required.

journal_name

Anaesthesia

journal_title

Anaesthesia

authors

Berry PA,Bernal W,Pagliuca A,Sizer E,Salisbury JR,Wendon JA,Auzinger G

doi

10.1111/j.1365-2044.2008.05584.x

subject

Has Abstract

pub_date

2008-11-01 00:00:00

pages

1249-54

issue

11

eissn

0003-2409

issn

1365-2044

pii

ANA5584

journal_volume

63

pub_type

杂志文章
  • The immediate care of acute renal failure.

    abstract::This article does not attempt to answer all the questions which might arise with the immediate management of a patient with acute renal failure but an effort has been made to lay down some guidelines and discuss some of the points of controversy. It should be remembered that the management of acute renal failure is an...

    journal_title:Anaesthesia

    pub_type: 杂志文章

    doi:10.1111/j.1365-2044.1977.tb11610.x

    authors: Rainford DJ

    更新日期:1977-03-01 00:00:00

  • Sensitivity to propofol in the elderly.

    abstract::Two studies were carried out on 609 fit, unpremedicated patients to assess the influence of patient age on the response to the rapidly-acting hindered phenol, propofol, which is being evaluated for induction of anaesthesia. In the first study, 1.25 mg/kg was injected over 20 seconds followed by 10-mg increments every ...

    journal_title:Anaesthesia

    pub_type: 杂志文章

    doi:10.1111/j.1365-2044.1986.tb13271.x

    authors: Dundee JW,Robinson FP,McCollum JS,Patterson CC

    更新日期:1986-05-01 00:00:00

  • Regional anaesthesia for repeat Caesarean section in a patient with phantom limb pain.

    abstract::The triggering of phantom limb pain by subarachnoid or epidural anaesthesia has been well described leading to the suggestion that neuraxial regional anaesthesia is relatively contraindicated in lower limb amputees. We report our experience of the provision of anaesthesia for repeat Caesarean section on two occasions ...

    journal_title:Anaesthesia

    pub_type: 杂志文章

    doi:10.1111/j.1365-2044.1996.tb07657.x

    authors: Uncles DR,Glynn CJ,Carrie LE

    更新日期:1996-01-01 00:00:00

  • Glycopyrrolate: pharmacology and clinical use.

    abstract::This is a review of glycopyrrolate whose function in clinical practice is compared with that of atropine. ...

    journal_title:Anaesthesia

    pub_type: 杂志文章

    doi:10.1111/j.1365-2044.1983.tb12525.x

    authors: Mirakhur RK,Dundee JW

    更新日期:1983-12-01 00:00:00

  • An unusual complication of lithotripsy.

    abstract::The case described illustrates a most unusual course of events due to a perforation in the wall of the bladder during transurethral lithotripsy. Irrigation fluid forced its way retroperitoneally to the mediastinum. The differential diagnostic problems encountered are discussed. ...

    journal_title:Anaesthesia

    pub_type: 杂志文章

    doi:10.1111/j.1365-2044.1983.tb12160.x

    authors: Sundnes KO,Vaagenes P,Kvarstein B

    更新日期:1983-07-01 00:00:00

  • Ventricular fibrillation after accidental injection of bupivacaine into the pericardium.

    abstract::A postoperative cardiac surgical patient developed ventricular fibrillation immediately after accidental pericardial injection of bupivacaine at room temperature. The possible causes, which include systemic toxicity, local vasoconstriction with myocardial ischaemia, local toxic effect of bupivacaine or local hypotherm...

    journal_title:Anaesthesia

    pub_type: 杂志文章

    doi:10.1111/j.1365-2044.1992.tb04202.x

    authors: Even BJ,De Jongh RF,De Hert SG

    更新日期:1992-12-01 00:00:00

  • A randomised comparison of the Portex Softseal laryngeal mask airway with the LMA-Unique during anaesthesia.

    abstract::We have compared the performance of the single use laryngeal airway devices Softseal and LMA-Unique in a randomised comparative trial in anaesthetised healthy patients who did not receive neuromuscular blockade. Primary outcome was success of airway placement. Secondary outcomes included manipulations and complication...

    journal_title:Anaesthesia

    pub_type: 杂志文章,随机对照试验

    doi:10.1111/j.1365-2044.2005.04330.x

    authors: Cook TM,Trümpelmann P,Beringer R,Stedeford J

    更新日期:2005-12-01 00:00:00

  • Temperature course and distribution during plasma heating with a microwave device.

    abstract::In spite of the much shorter thawing times, the use of microwave devices for heating units of fresh frozen plasma is still being discussed. Concerns about general and localised overheating are the main arguments against the use of microwave devices. We evaluated the warming of fresh frozen plasma using the recently in...

    journal_title:Anaesthesia

    pub_type: 杂志文章

    doi:10.1046/j.1365-2044.2003.03086.x

    authors: Hirsch J,Bach R,Menzebach A,Welters ID,Dietrich GV,Hempelmann G

    更新日期:2003-05-01 00:00:00

  • Anaesthetic manpower in the future in the UK.

    abstract::The short-term objective of the DHSS of a 1:1 consultant: junior ratio by 1988 is compatible with current trends in consultant expansion and implies no reduction in registrars before then. The target of doubling the number of consultants in 15 years cannot be met in anaesthesia without a fairly sharp, and relatively s...

    journal_title:Anaesthesia

    pub_type: 杂志文章

    doi:10.1111/j.1365-2044.1982.tb01862.x

    authors: Vickers MD

    更新日期:1982-09-01 00:00:00

  • The incidence of Horner's syndrome during lumbar extradural for elective Caesarean section and provision of analgesia during labour.

    abstract::One hundred and fifty women in labour provided with extradural analgesia were monitored and an incidence of Horner's syndrome of 1.33% was noted. Fifty women undergoing Caesarean section under extradural analgesia were also monitored and an incidence of Horner's syndrome of 4% was noted. From the results we found it i...

    journal_title:Anaesthesia

    pub_type: 杂志文章

    doi:

    authors: Clayton KC

    更新日期:1983-06-01 00:00:00

  • Comparison of the C-MAC videolaryngoscope with the Macintosh, Glidescope, and Airtraq laryngoscopes in easy and difficult laryngoscopy scenarios in manikins.

    abstract::The C-MAC comprises a Macintosh blade connected to a video unit. The familiarity of the Macintosh blade, and the ability to use the C-MAC as a direct or indirect laryngoscope, may be advantageous. We wished to compare the C-MAC with Macintosh, Glidescope and Airtraq laryngoscopes in easy and simulated difficult laryng...

    journal_title:Anaesthesia

    pub_type: 杂志文章,随机对照试验

    doi:10.1111/j.1365-2044.2010.06307.x

    authors: McElwain J,Malik MA,Harte BH,Flynn NM,Laffey JG

    更新日期:2010-05-01 00:00:00

  • Propofol and hypothermic cardiopulmonary bypass. Vasodilation and enhanced metabolic protection?

    abstract::The effects of propofol during low flow (1.6 l.min-1.m-2) hypothermic (27-29 degrees C) cardiopulmonary bypass on systemic haemodynamic and metabolic variables were studied in 20 patients in a parallel group comparison. Patients in the control group underwent two consecutive control periods, whereas those in the propo...

    journal_title:Anaesthesia

    pub_type: 杂志文章

    doi:10.1111/j.1365-2044.1992.tb02217.x

    authors: Laycock GJ,Alston RP

    更新日期:1992-05-01 00:00:00

  • A systematic review and meta-analysis of the i-gel® vs laryngeal mask airway in children.

    abstract::We systematically reviewed randomised controlled trials of the i-gel® vs different types of laryngeal mask airway in children. We included nine studies. There was no evidence for differences in: rate of insertion at first attempt; insertion time; ease of insertion; or gastric tube insertion. The mean (95% CI) orophary...

    journal_title:Anaesthesia

    pub_type: 杂志文章,meta分析,评审

    doi:10.1111/anae.12746

    authors: Choi GJ,Kang H,Baek CW,Jung YH,Woo YC,Cha YJ

    更新日期:2014-11-01 00:00:00

  • Halothane hepatitis in an 11-month-old child.

    abstract::Halothane hepatitis is extremely rare in childhood. However, this occurred in an 11-month-old infant, following multiple exposure to halothane. The diagnosis was confirmed by detection of specific antibodies to halothane-sensitised rabbit hepatocytes. The anaesthetic technique for a subsequent procedure with a halotha...

    journal_title:Anaesthesia

    pub_type: 杂志文章

    doi:10.1111/j.1365-2044.1986.tb13053.x

    authors: Whitburn RH,Sumner E

    更新日期:1986-06-01 00:00:00

  • Reduction of acute haemorrhage with aprotinin.

    abstract::We describe the use of aprotinin in two patients to control life threatening haemorrhage due to coagulopathy when other therapeutic measures had failed. We review the use of aprotinin and give a rationale for its use in acute coagulopathy. ...

    journal_title:Anaesthesia

    pub_type: 杂志文章

    doi:10.1111/j.1365-2044.1993.tb07014.x

    authors: Valentine S,Williamson P,Sutton D

    更新日期:1993-05-01 00:00:00

  • The association of the distance walked in 6 min with pre-operative peak oxygen consumption and complications 1 month after colorectal resection.

    abstract::We measured the distance 112 patients walked in 6 min, as well as their peak oxygen consumption pedalling a bicycle, week before scheduled resection of benign or malignant colorectal disease. The distance walked correlated with peak oxygen consumption, the former 'accounting' for about half the variation in the latter...

    journal_title:Anaesthesia

    pub_type: 杂志文章,随机对照试验

    doi:10.1111/anae.12329

    authors: Lee L,Schwartzman K,Carli F,Zavorsky GS,Li C,Charlebois P,Stein B,Liberman AS,Fried GM,Feldman LS

    更新日期:2013-08-01 00:00:00

  • Adverse airway events during brief nasal inhalations of volatile anaesthetics: the effect of humidity and repeated exposure on incidence in volunteers preselected by response to desflurane.

    abstract::Twelve volunteers known to have airways that responded adversely to 2.0 MAC desflurane were recruited. Each volunteer inhaled three single breaths of each of 0.5, 1.0 and 2.0 MAC of sevoflurane, halothane, isoflurane, desflurane and balance air, with breaths of air between, whilst breathing nasally through a face mask...

    journal_title:Anaesthesia

    pub_type: 杂志文章

    doi:10.1046/j.1365-2044.2003.02965.x

    authors: Wilkes AR,Raj N,Hall JE

    更新日期:2003-03-01 00:00:00

  • A comparison of the clinical use of the Laryngeal Tube S and the ProSeal Laryngeal Mask Airway by first-month anaesthesia residents in anaesthetised patients.

    abstract::The Laryngeal Tube S and the LMA-ProSeal are supraglottic instruments with an improved airway seal and a drainage tube to protect against regurgitation and to facilitate passage of a gastric tube. We compared the feasibility of these two instruments in a randomised, controlled clinical trial. One hundred and sixty pat...

    journal_title:Anaesthesia

    pub_type: 杂志文章,随机对照试验

    doi:10.1111/j.1365-2044.2007.05073.x

    authors: Klaver NS,Kuizenga K,Ballast A,Fidler V

    更新日期:2007-07-01 00:00:00

  • Survey of 1057 patients receiving postoperative patient-controlled epidural analgesia.

    abstract::Data were collected from 1057 consecutive patients who received patient-controlled epidural analgesia for postoperative pain relief, using 0.1% bupivacaine with 5 microg x ml(-1) fentanyl in all cases. Prescriptions were not otherwise standardised. On the first postoperative day, 741/801 patients (92.5%) had adequate ...

    journal_title:Anaesthesia

    pub_type: 杂志文章

    doi:10.1046/j.1365-2044.2001.01763-6.x

    authors: Wigfull J,Welchew E

    更新日期:2001-01-01 00:00:00

  • Hypophosphataemia and its consequences in patients following open heart surgery.

    abstract::Plasma phosphate concentration (Pi), red cell 2,3-diphosphoglycerate (2,3-DPG) and adenosine triphosphate (ATP) concentrations were measured pre-operatively and at intervals after operation for 30 h in twelve patients (nine males and three females, 44--61 years of age), who underwent open heart surgery. All patients r...

    journal_title:Anaesthesia

    pub_type: 杂志文章

    doi:10.1111/j.1365-2044.1978.tb08419.x

    authors: Swaminathan R,Morgan DB,Ionescu M,Hill GL

    更新日期:1978-07-01 00:00:00

  • Haemodynamic and catecholamine stress responses to the Laryngeal Tube-Suction Airway and the Proseal Laryngeal Mask Airway.

    abstract::Supraglottic airway devices such as the ProSeal Laryngeal Mask Airway (PLMA) and Laryngeal Tube-Suction Airway (LTS) that provoke the least stress responses could be beneficial in many situations, especially in patients with cardiovascular disease. We compared the haemodynamic and catecholamine stress response of the ...

    journal_title:Anaesthesia

    pub_type: 杂志文章,随机对照试验

    doi:10.1111/j.1365-2044.2006.04548.x

    authors: Dahaba AA,Prax N,Gaube W,Gries M,Rehak PH,Metzler H

    更新日期:2006-04-01 00:00:00

  • Pre-oxygenation and apnoea in pregnancy: changes during labour and with obstetric morbidity in a computational simulation.

    abstract::Using the Nottingham Physiology Simulator, we investigated the effects on pre-oxygenation and apnoea during rapid sequence induction of labour, obesity, sepsis, pre-eclampsia, maternal haemorrhage and multiple pregnancy in term pregnancy. Pre-oxygenation with 100% oxygen was followed by simulated rapid sequence induct...

    journal_title:Anaesthesia

    pub_type: 杂志文章

    doi:10.1111/j.1365-2044.2008.05785.x

    authors: McClelland SH,Bogod DG,Hardman JG

    更新日期:2009-04-01 00:00:00

  • The management of tracheal rupture using bilateral bronchial intubation.

    abstract::The management of a patient who required positive pressure ventilation following pharyngolaryngo-oesophagectomy during which tracheal injury was sustained is described. Ventilation with a tracheal tube resulted in a massive pneumoperitoneum. Bilateral bronchial intubation was employed with success. ...

    journal_title:Anaesthesia

    pub_type: 杂志文章

    doi:10.1111/j.1365-2044.1993.tb06906.x

    authors: Mitchell JB,Ward PM

    更新日期:1993-03-01 00:00:00

  • Pulse oximetry. An assessment in anaesthetised dental patients.

    abstract::The applications of a pulse oximeter were studied in dental day case surgery using nasal mask anaesthesia. Changes in arterial oxygen saturation were sensitively and rapidly detected, in the absence of cyanosis. Impaired oxygenation can be detected before cyanosis develops. ...

    journal_title:Anaesthesia

    pub_type: 杂志文章

    doi:10.1111/j.1365-2044.1986.tb12750.x

    authors: Clapham MC,Mackie AM

    更新日期:1986-10-01 00:00:00

  • Effects of lamotrigine on pain-induced chemo-somatosensory evoked potentials.

    abstract::Lamotrigine, a sodium channel blocker that selectively inhibits the neuronal release of glutamate, has been shown to produce analgesia in acute and chronic pain models in rats without causing noticeable sedation. After oral administration it also reduces pain scores, as assessed by the cold pain test, in volunteers. T...

    journal_title:Anaesthesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1046/j.1365-2044.1999.00959.x

    authors: Klamt JG,Posner J

    更新日期:1999-08-01 00:00:00

  • Electronic and disposable patient-controlled analgesia systems. A comparison of the Graseby and Baxter systems after major gynaecological surgery.

    abstract::We have compared the performance of the Baxter disposable with the Graseby electronic patient-controlled analgesia system in 30 patients following major gynaecological surgery. Patients were allocated randomly to receive analgesia via the Baxter or Graseby device for postoperative pain relief. There were no significan...

    journal_title:Anaesthesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1111/j.1365-2044.1992.tb02020.x

    authors: Robinson SL,Rowbotham DJ,Mushambi M

    更新日期:1992-02-01 00:00:00

  • Propofol for long-term sedation in the intensive care unit. A comparison with papaveretum and midazolam.

    abstract::Thirty-seven patients with a wide range of illnesses were studied during mechanical ventilation of the lungs in an intensive care unit. Fifteen were sedated with a continuous propofol infusion, with analgesia provided by bolus doses of papaveretum. Twelve received a continuous infusion of papaveretum, supplemented by ...

    journal_title:Anaesthesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1111/j.1365-2044.1990.tb14777.x

    authors: Harris CE,Grounds RM,Murray AM,Lumley J,Royston D,Morgan M

    更新日期:1990-05-01 00:00:00

  • Nalbuphine for obstetric analgesia. A comparison of nalbuphine with pethidine for pain relief in labour when administered by patient-controlled analgesia (PCA).

    abstract::A double-blind, randomised study of 60 patients who received intravenous increments of nalbuphine 3 mg or pethidine 15 mg by patient-controlled analgesia during the first stage of labour, was carried out. Pain intensity, sedation, uterine contractions, maternal cardioventilatory variables and fetal heart rate were rec...

    journal_title:Anaesthesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1111/j.1365-2044.1987.tb05313.x

    authors: Frank M,McAteer EJ,Cattermole R,Loughnan B,Stafford LB,Hitchcock AM

    更新日期:1987-07-01 00:00:00

  • Effect of premedication with controlled-release oral morphine on postoperative pain. A comparison with intramuscular morphine.

    abstract::Thirty fit patients presenting for elective total hip replacement were randomly allocated to receive a premedication of 60 or 90 mg controlled-release oral morphine or 15 mg intramuscular morphine. Postoperative analgesia was assessed using on-demand intravenous pethidine supplementation requirements. In 15 patients f...

    journal_title:Anaesthesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1111/j.1365-2044.1985.tb10844.x

    authors: Slowey HF,Reynolds AD,Mapleson WW,Vickers MD

    更新日期:1985-05-01 00:00:00

  • The implications of HIV for the anaesthetist and the intensivist.

    abstract::The acquired immune deficiency syndrome has reached pandemic proportions. Anaesthetists should be aware of the implications of dealing with increasing numbers of both diagnosed and undiagnosed, symptomatic and asymptomatic, human immunodeficiency virus-infected patients in the fields of intensive therapy, operating th...

    journal_title:Anaesthesia

    pub_type: 杂志文章,评审

    doi:10.1046/j.1365-2044.2000.01265.x

    authors: Avidan MS,Jones N,Pozniak AL

    更新日期:2000-04-01 00:00:00