Division of Newborn Medicine, Children's Hospital Boston, Boston, Massachusetts, USA.
Am J Perinatol. 2011 May;28(5):337-46. doi: 10.1055/s-0030-1268710. Epub 2010 Nov 18.
We present the clinical course of three neonates with proven enteroviral infection and an initial clinical picture suggestive of hemophagocytic lymphohistiocytosis (HLH). After a complete workup, only one was treated for HLH. Of particular interest, the first newborn presented with hemophagocytic cells in the cerebrospinal fluid (CSF) and proved to have enteroviral meningoencephalitis but was ultimately not diagnosed with HLH. A fourth infant, who fulfilled the diagnostic criteria for HLH but did not have enteroviral infection, is included for comparison. We suggest that severe neonatal enteroviral infection and HLH are difficult to distinguish. Careful assessment is recommended, as prognosis and treatment differ between these two entities. Literature regarding neonatal enteroviral infection and HLH is reviewed, to demonstrate the continuum between the inflammation triggered by enteroviral infection and the occurrence of HLH, as well as their comparable CSF findings.
我们介绍了三例经证实的肠病毒感染新生儿的临床病程，其初始临床表现提示噬血细胞性淋巴组织细胞增生症（HLH）。经过全面检查，只有一例被诊断为 HLH 并接受治疗。特别值得注意的是，首例新生儿的脑脊液中存在噬血细胞细胞，证实患有肠病毒性脑膜脑炎，但最终未被诊断为 HLH。另一位符合 HLH 诊断标准但无肠病毒感染的第四例婴儿也被纳入进行比较。我们建议，严重的新生儿肠病毒感染和 HLH 很难区分。建议进行仔细评估，因为这两种情况的预后和治疗方法不同。我们回顾了有关新生儿肠病毒感染和 HLH 的文献，以证明由肠病毒感染引发的炎症与 HLH 的发生之间存在连续性，以及它们在脑脊液表现方面的相似性。
