A case of hemophagocytic syndrome as a complication of Plasmodium vivax malaria

DOI: 10.4236/ojcd.2013.34028   PDF   HTML     2,730 Downloads   4,700 Views  


Hemophagocytic lymphohistiocytosis syndrome (HPS) is a potentially fatal hyperinflammatory response characterized by a generalized histiocytic proliferation with marked hemophagocytosis in bone marrow [1]. Hemophagocytic syndrome has been associated with genetic mutations, autoimmune diseases, hematological malignancies or infections [2,3]. According to the data from Centre for Disease Control and prevention (CDC) Plasmodium falciparum has been associated with HPS but not the Plasmodium vivax [4-7]. We report a case of hemophagocytic syndrome as a complication of Plasmodium vivax malaria which is a rare presentation according to the data. This patient presented with high grade fever with chills (P. vivax positive), fever however did not respond to anti-malarials. The patient continued to have high grade fever with altered sensorium and deranged liver function with pancytopenia. Since she fulfilled the criteria of (HPS), patient was put on injectable steroids and responded dramatically. Hemophagocytic syndrome is a potentially fatal syndrome and therefore high index suspicion and early treatment is the key to reduce the mortatlity.

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Mukharjee, A. , Sagar, C. , Fulara, S. , Patil, U. and Jawanjal, M. (2013) A case of hemophagocytic syndrome as a complication of Plasmodium vivax malaria. Open Journal of Clinical Diagnostics, 3, 156-158. doi: 10.4236/ojcd.2013.34028.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] Imashuku, S. (1997) Differential diagnosis of hemophagocytic syndrome: Underlying disorders and selection of the most effective treatment. International Journal of Hematology, 66, 135-151. http://dx.doi.org/10.1016/S0925-5710(97)00584-7
[2] Fisman, D.N. (2000) Hemophagocytic syndromes and infection. Emerging Infectious Diseases, 6, 601-608. http://dx.doi.org/10.3201/eid0606.000608
[3] Vinoth, P.N., Thomas, K.A., Selvan, S.M., Suman, D.F. and Scott, J.X. (2011) Hemophagocytic syndrome associated with plasmodium falciparum infection. Indian Journal of Pathology and Microbiology, 54, 594-596. http://dx.doi.org/10.4103/0377-4929.85105
[4] Anwar, M., Saleem, M. and Malik, I.A. (1995) Severe haemophagocytic syndromein falciparum malaria. Journal of Pakistan Medical Association, 45, 302-303.
[5] Ohno, T., Shirasaka, A., Sugiyama, T. and Furukawa, H. (1996) Hemophagocyticsyndrome induced by plasmodium falciparum malaria infection. International Journal of Hematology, 64, 263-266. http://dx.doi.org/10.1016/0925-5710(96)00495-1
[6] Retornaz, F., Seux, V., Arnoulet, C., Durand, J.M., Sainty, D. and Soubeyrand, J. (2000) Plasmodium falciparum malaria infection complicated byhaemophagocytic syndrome in an old man. Acta Haematologica, 103, 224-225. http://dx.doi.org/10.1159/000041055
[7] Sermet-Gaudelus, I., Abadie, V., Stambouli, F., Hennequin, C., Lenoir, G. and Gendrel, D. (2000) Haemophagocytic syndrome in Plasmodiumfalciparum malaria. Acta Paediatrica, 89, 368-369. http://dx.doi.org/10.1111/j.1651-2227.2000.tb01343.x
[8] Henter, J.I., Elinder, G., Ost, A. and the FHL Study Group of the Histiocyte Society (1991) Diagnostic guidelines for hemophagocytic lymphohistiocytosis. Seminars in Oncology, 18, 29-33.
[9] Janke, G., Henter, J.I. and Imashuku, S. (2005) Clinical aspects and therapy of hemophagocyticlymphohistiocytosis. In: Weitzman, S. and Egler, R.M., Eds., Histiocytic Disorders of Children and Adults. Cambridge University Press, Cambridge, 353-379.
[10] Fukaya, S., Yasuda, S., Hashimoto, T., et al. (2008) Clinical features of haemophagocytic syndrome in patients with systemic autoimmune diseases: Analysis of 30 cases. Rheumatology (Oxford), 47, 1686. http://dx.doi.org/10.1093/rheumatology/ken342
[11] Risma, K. and Jordan, M.B. (2012) Hemophagocytic lymphohistiocytosis: Updates and evolving concepts. Current Opinion in Pediatrics, 24, 9. http://dx.doi.org/10.1097/MOP.0b013e32834ec9c1
[12] Henter, J.-I., Samuelsson-Horne, A., Aricò, M., et al. (2002) Treatment of hemophagocyticlymphohistiocytosis with HLH-94 immunochemotherapyand bone marrow transplantation. Blood, 100, 2367-2373. http://dx.doi.org/10.1182/blood-2002-01-0172

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