Cholestatic jaundice: a unique presentation leading to the diagnosis of HLH with Hodgkin lymphoma, HIV and EBV

Hira Shaikh; Soorih Shaikh; Amir Kamran; Prerna Mewawalla

doi:10.1136/bcr-2018-224424

Back

Cholestatic jaundice: a unique presentation leading to the diagnosis of HLH with Hodgkin lymphoma, HIV and EBV

Journal article

Open access

Peer reviewed

Cholestatic jaundice: a unique presentation leading to the diagnosis of HLH with Hodgkin lymphoma, HIV and EBV

Hira Shaikh, Soorih Shaikh, Amir Kamran and Prerna Mewawalla

BMJ case reports, Vol.2018, 224424

05/12/2018

DOI: 10.1136/bcr-2018-224424

PMCID: PMC6040570

PMID: 29754142

Files and links (1)

url

https://europepmc.org/articles/pmc6040570View

Published (Version of record) Open Access

Abstract

Haemophagocytic lymphohistiocytosis (HLH) is a syndrome of dysregulated immune activity with macrophage activation that can manifest as pancytopenia, coagulopathy and other laboratory abnormalities, usually progressing to multiorgan failure and death. This report documents the rarely reported association between HLH and Hodgkin's lymphoma (HL) with simultaneous HIV and Epstein-Barr virus (EBV) and complete resolution with chemotherapy. The patient initially presented with cholestatic jaundice. He was then found to have HL associated with HLH with coexistent HIV and EBV viraemia. A-Brentuximab-VD regimen for the lymphoma was initiated, resulting in rapid resolution of HLH and ultimately remission of HL. HLH is a syndrome known to have high mortality; thus, early diagnosis and prompt treatment are crucial. Usual presentation includes non-specific symptoms and can easily be overlooked. This case highlights the importance of diagnosing the condition in unusual settings and attempting treatment by targeting the cause of HLH, HL in our case.

Abdominal Pain

Adult

Checklist

Drug Therapy, Combination

Epstein-Barr Virus Infections - diagnosis

Epstein-Barr Virus Infections - drug therapy

Epstein-Barr Virus Infections - immunology

Fever

Guidelines as Topic

HIV Infections - diagnosis

HIV Infections - drug therapy

HIV Infections - immunology

Hodgkin Disease - diagnosis

Hodgkin Disease - drug therapy

Hodgkin Disease - immunology

Humans

Jaundice, Obstructive

Lymphohistiocytosis, Hemophagocytic - diagnosis

Lymphohistiocytosis, Hemophagocytic - drug therapy

Lymphohistiocytosis, Hemophagocytic - immunology

Male

Time-to-Treatment

Treatment Outcome

Details

Title: Subtitle: Cholestatic jaundice: a unique presentation leading to the diagnosis of HLH with Hodgkin lymphoma, HIV and EBV
Creators: Hira Shaikh - Allegheny Health Network
Soorih Shaikh - Allegheny Health Network
Amir Kamran - Allegheny Health Network
Prerna Mewawalla - Allegheny Health Network
Resource Type: Journal article
Publication Details: BMJ case reports, Vol.2018, 224424
DOI: 10.1136/bcr-2018-224424
PMID: 29754142
PMCID: PMC6040570
NLM abbreviation: BMJ Case Rep
ISSN: 1757-790X
eISSN: 1757-790X
Publisher: BMJ
Language: English
Date published: 05/12/2018
Academic Unit: Internal Medicine
Record Identifier: 9984695681902771

Metrics

7 Record Views