Etoposide combined with ruxolitinib for refractory hemophagocytic lymphohistiocytosis during pregnancy: a case report and literature review
Autor: | Jingguo Wu, Yongwei Zhang, Xiao-li Jing, Shuoshan Wang, Junlin Wu, Hao Tang |
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Rok vydání: | 2019 |
Předmět: |
Adult
Oncology medicine.medical_specialty Ruxolitinib Disease Lymphohistiocytosis Hemophagocytic 03 medical and health sciences 0302 clinical medicine Refractory Pregnancy Internal medicine Nitriles Humans Topoisomerase II Inhibitors Medicine Protein Kinase Inhibitors Etoposide Janus Kinases Hemophagocytic lymphohistiocytosis business.industry Hematology medicine.disease Antineoplastic Agents Phytogenic Pregnancy Complications Pyrimidines 030220 oncology & carcinogenesis Pyrazoles Drug Therapy Combination Female business 030215 immunology medicine.drug |
Zdroj: | Hematology. 24:751-756 |
ISSN: | 1607-8454 |
Popis: | Hemophagocytic lymphohistiocytosis (HLH) is an immune-mediated disorder caused by uncontrolled inflammatory responses and the activation of T lymphocytes. This life-threatening disease, characterized by fever, cytopenia and hepatosplenomegaly, is extremely rare during pregnancy with high mortality. Despite the improvement of treatment regimen in recent years, HLH is still a great challenge for clinicians. Here, we described a 26-year-old woman who admitted to our hospital at her first pregnancy with pyrexia. Her condition continued to deteriorate after receiving broad-spectrum antimicrobials, presenting with fever, pancytopenia, hepatosplenomegaly, ferritin ≥ 500 μg/L, hemophagocytosis and low NK-cell activity. HLH was eventually diagnosed by clinical manifestation and laboratory examination results. Then the patient recovered well after treatment with etoposide combined with ruxolitinib therapy and underwent successful induced-labor operation. Additionally, we summarized similar cases from the literature to improve the management of HLH during pregnancy. In conclusion, this study highlights the challenges and difficulties in the diagnosis and management of patients with HLH during pregnancy. Moreover, this is the first case report of etoposide combined with ruxolitinib in the treatment of patients with refractory secondary HLH during pregnancy. |
Databáze: | OpenAIRE |
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