A neurologic presentation of familial hemophagocytic lymphohistiocytosis which mimicked septic emboli to the brain.

Abstract:

:Familial hemophagocytic lymphohistiocytosis is an inherited deficiency of natural killer cell function and excessive cytokine activity, which predominantly presents in early childhood. The initial symptoms of familial hemophagocytic lymphohistiocytosis are often nonspecific but may be predominantly neurologic. The case presented here describes an 18-month-old boy who initially presented with fever, encephalopathy, and hemiparesis. He had innumerable brain lesions visualized on magnetic resonance imaging scans. An infectious etiology was excluded, and brain, liver, and bone marrow biopsies were nonspecific but consistent with hemophagocytic lymphohistiocytosis. Cells were sent for flow cytometry perforin analysis, which demonstrated defective natural killer cell function. A diagnosis of familial hemophagocytic lymphohistiocytosis was confirmed by mutation analysis and decreased expression of the perforin gene, in the patient and immediate family members. These results showed the patient to be a compound heterozygote for perforin mutations. His case illustrates the potential for a fulminant neurological presentation of familial hemophagocytic lymphohistiocytosis with widespread lesions in the brain.

journal_name

J Child Neurol

authors

Turtzo LC,Lin DD,Hartung H,Barker PB,Arceci R,Yohay K

doi

10.1177/0883073807304203

subject

Has Abstract

pub_date

2007-07-01 00:00:00

pages

863-8

issue

7

eissn

0883-0738

issn

1708-8283

pii

22/7/863

journal_volume

22

pub_type

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