Familial hemophagocytic lymphohistiocytosis. Clinical review based on the findings in seven children

Acta Paediatr Scand. 1991 Mar;80(3):269-77. doi: 10.1111/j.1651-2227.1991.tb11849.x.

Abstract

Clinical, laboratory, and histological findings in FHL of diagnostic importance were intermittent fever, hepatosplenomegaly, peripheral blood cytopenia, hypertriglyceridemia, hypofibrinogenemia, and a lymphohistiocytic accumulation with hemophagocytosis in the mononuclear phagocytic system. Fine-needle aspiration biopsy from the spleen appeared to be a useful method for revealing hemophagocytosis. The treatment of induction and relapses, as well as the maintenance therapy, included administration of teniposide, etoposide, and corticosteroids. The regimen had to be individualized for each child since the clinical course was highly variable. Half of the children given successful induction therapy (3/6) are still alive with over a 3-year survival after diagnosis.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Biopsy, Needle
  • Child, Preschool
  • Combined Modality Therapy
  • Etoposide / therapeutic use
  • Exchange Transfusion, Whole Blood
  • Female
  • Glucocorticoids / therapeutic use
  • Histiocytosis, Non-Langerhans-Cell / diagnosis
  • Histiocytosis, Non-Langerhans-Cell / therapy*
  • Humans
  • Immunization, Passive
  • Infant
  • Male
  • Methotrexate / therapeutic use
  • Plasmapheresis
  • Spleen / pathology
  • Teniposide / therapeutic use

Substances

  • Glucocorticoids
  • Etoposide
  • Teniposide
  • Methotrexate