PMID- 38496135
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20240319
IS  - 2168-8184 (Print)
IS  - 2168-8184 (Electronic)
IS  - 2168-8184 (Linking)
VI  - 16
IP  - 2
DP  - 2024 Feb
TI  - Hemophagocytic Lymphohistiocytosis Associated With Human Herpesvirus-6 (HHV-6) 
      Infection in an Immunocompetent Adult: A Case Report.
PG  - e54299
LID - 10.7759/cureus.54299 [doi]
LID - e54299
AB  - Hemophagocytic lymphohistiocytosis (HLH) is a rare disorder characterized by 
      extreme immune activation and excessive inflammation. It has been reported in 
      patients with familial cases, immunodeficiencies, malignancies, stem cell 
      transplants, and viral etiologies. This report describes acquired HLH associated 
      with Human herpesvirus-6 (HHV-6) infection in a 76-year-old previously healthy 
      male. The patient was admitted to the hospital due to fever, chills, and 
      abdominal pain. The diagnostic workup revealed gallbladder wall thickening on 
      imaging, concerning for cholecystitis. The patient was started on treatment for 
      sepsis. Further clinical deterioration led to an extensive infectious workup. The 
      patient was found to have elevated soluble IL-2Ra levels, and a bone marrow 
      biopsy was performed, which revealed HLH. A positive HHV-6 polymerase chain 
      reaction in the cerebrospinal fluid and serum confirmed the viral infection. 
      Treatment involved the initiation of high-dose steroids, etoposide, and 
      ganciclovir. Despite these interventions, the patient's clinical status worsened, 
      leading to the implementation of comfort measures, and the patient eventually 
      died. This case underscores the importance of considering HHV-6 as a potential 
      cause of HLH in immunocompetent adults. From this case, we infer that a 
      heightened level of vigilance is necessary to recognize and intervene in this 
      challenging condition promptly.
CI  - Copyright (c) 2024, Rahman et al.
FAU - Rahman, Ateeb Ur
AU  - Rahman AU
AD  - Department of Internal Medicine, Penn State Health, Camp Hill, USA.
FAU - Baig, Fahad
AU  - Baig F
AD  - Department of Medicine, Rashid Latif Medical College, Lahore, PAK.
FAU - Javid Chaudhary, Umar Iqbal
AU  - Javid Chaudhary UI
AD  - Department of Medicine, Arif Memorial Teaching Hospital, Rashid Latif Medical 
      College, Lahore, PAK.
FAU - Ashraf, Muhammad Bilal
AU  - Ashraf MB
AD  - Department of Community Medicine, Rashid Latif Medical College, Lahore, PAK.
FAU - Jawaid, Muhammad Daim
AU  - Jawaid MD
AD  - Department of Medicine, Rashid Latif Medical College, Lahore, PAK.
FAU - Chaudary, Amna
AU  - Chaudary A
AD  - Department of Internal Medicine, Penn State Health, Camp Hill, PAK.
FAU - Tariq, Munim
AU  - Tariq M
AD  - Department of Internal Medicine, The Rotherham NHS Foundation Trust, Sheffield, 
      GBR.
LA  - eng
PT  - Case Reports
DEP - 20240216
PL  - United States
TA  - Cureus
JT  - Cureus
JID - 101596737
PMC - PMC10944635
OTO - NOTNLM
OT  - cytokine release storm
OT  - hemophagocytic lymphohistiocytosis (hlh)
OT  - human herpes virus type 6
OT  - hyperferritinemia
OT  - secondary hemophagocytic lymphohistiocytosis (hlh)
COIS- The authors have declared that no competing interests exist.
EDAT- 2024/03/18 06:42
MHDA- 2024/03/18 06:43
PMCR- 2024/02/16
CRDT- 2024/03/18 04:32
PHST- 2024/02/16 00:00 [accepted]
PHST- 2024/03/18 06:43 [medline]
PHST- 2024/03/18 06:42 [pubmed]
PHST- 2024/03/18 04:32 [entrez]
PHST- 2024/02/16 00:00 [pmc-release]
AID - 10.7759/cureus.54299 [doi]
PST - epublish
SO  - Cureus. 2024 Feb 16;16(2):e54299. doi: 10.7759/cureus.54299. eCollection 2024 
      Feb.