Hemophagocytic lymphohistiocytosis is associated with Bartonella henselae infection in a patient with multiple susceptibility genes.

Annals of Clinical Microbiology and Antimicrobials
Tianjun YangAijun Pan

Abstract

Adult-onset hemophagocytic lymphohistiocytosis (HLH) is a rare and life-threatening condition, which is often triggered by certain types of infection, cancer and numerous autoimmune diseases; however, of the numerous infectious triggers associated with HLH, the consequences of Bartonella henselae infection have been rarely reported. A 48-year-old female presented with a 20-day history of intermittent fever accompanied by systemic rash, fatigue, anorexia and weight loss later she developed shock and unconsciousness. Blood tests showed a reduction of leukocyte, anemia and thrombocytopenia, and pathological results of a bone marrow biopsy confirmed hemophagocytic activity. Metagenomic next-generation sequencing (mNGS) analysis of the lymph node detected the presence of B. henselae. Whole exome sequencing revealed two gene variants, STXBP2 and IRF5, in this adult patient with secondary HLH. Then, she received minocycline and rifampin combination anti-infective therapy. Intravenous immunoglobulin for 5 days followed by a high dose of methylprednisolone were also administered. The patient was successfully discharged from the intensive care unit and remained in good condition after 2 months of follow-up. mNGS served crucial roles in o...Continue Reading

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Citations

Apr 27, 2021·The Pediatric Infectious Disease Journal·Yoshihiro AokiKatsuhiko Kitazawa

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Methods Mentioned

BETA
biopsy
exome sequencing
Exome Capture
PCR
biopsies
ELISA

Software Mentioned

PROVEAN
BurrowsWheeler Aligner ( BWA
Polyphen2
SIFT
GATK
BGISEQ
500

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