Acute Respiratory Distress Syndrome as an Initial Presentation of Hemophagocytic Lymphohistiocytosis After Induction Therapy for Acute Myeloid Leukemia

作者：Nishikawa Takuro^*; Okamoto Yasuhiro; Tanabe Takayuki; Shinkoda Yuichi; Kodama Yuichi; Kakihana Yasuyuki; Goto Masamichi; Kawano Yoshifumi

来源：Pediatric Hematology and Oncology, 2011, 28(3): 244-248.

DOI：10.3109/08880018.2010.514038

• acute respiratory distress syndrome
• ferritin
• hemophagocytic lymphohistiocytosis
• hypercytokinemia
• sIL-2R

A 7-month-old girl with acute myeloid leukemia (AML) developed acute respiratory distress syndrome (ARDS) during the pancytopenic period after induction chemotherapy. Respiratory failure did not improve despite intensive treatments. Eventually, hemophagocytic lymphohistiocytosis (HLH) was diagnosed based on hemophagocytosis in bone marrow, and high soluble interleukin-2 receptor (sIL-2R) and ferritin levels. Even after cyclosporin A was started against HLH, she did not recover. Autopsy showed macrophage proliferation in bone marrow and lymph nodes. HLH should be considered, even in the pancytopenic period after chemotherapy, when patients develop ARDS that does not respond to supportive therapies.</.

• 出版日期2011-4