Fever-triggered Brugada syndrome in an adult patient presenting with hemophagocytic syndrome induced by Chlamydophila pneumoniae
| Autor: | Miguel Bigotte Vieira, Anabela Oliveira, Nuno Gaibino, Alexandra Pignatelli |
|---|---|
| Rok vydání: | 2015 |
| Předmět: |
Adult
Male medicine.medical_specialty Fever Hepatosplenomegaly medicine.disease_cause Gastroenterology Severity of Illness Index Lymphohistiocytosis Hemophagocytic Article Electrocardiography Bone Marrow Internal medicine Severity of illness medicine ST segment Humans Chlamydophila Infections Brugada syndrome Brugada Syndrome business.industry General Medicine Hypofibrinogenemia Chlamydophila pneumoniae medicine.disease Pancytopenia Anti-Bacterial Agents Doxycycline Immunology Hemophagocytosis medicine.symptom business |
| Zdroj: | BMJ case reports. 2015 |
| ISSN: | 1757-790X |
| Popis: | A previously healthy 29-year-old man was admitted to our hospital, with a 4-day history of fever (39°C), rigours, diaphoresis, fatigue and retro-orbital headache. On examination, he was febrile (37.8°C) and tachycardic (110 bpm). Laboratory work up revealed bicytopenia (white cell count 1.37×10(9)/L, platelets 60×10(9)/L) and an increase in C reactive protein (9 mg/dL). The ECG showed ST segment elevation in V1, V2 and V3 leads. The patient was admitted and investigation was initiated revealing prolonged fever (7 days), pancytopenia, hepatosplenomegaly, hyperferritinemia, hypertriglyceridemia, hypofibrinogenemia, elevated soluble CD25 and hemophagocytosis in bone marrow. Therefore, the patient presented 7 of the 8 diagnostic criteria of hemophagocytic syndrome. Laboratorial investigation for infectious causes was negative, except for IgA and IgG Chlamydophila pneumoniae. ECG re-evaluation on the day of discharge showed no ST segment elevation and no other abnormalities. Genetic testing for known mutations associated with hemophagocytic syndrome and Brugada syndrome did not show any mutations in these genes. |
| Databáze: | OpenAIRE |
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