Human immunodeficiency virus associated with haemophagocytic syndrome in pregnancy: a case report.

BACKGROUND

Haemophagocytic syndrome (HPS) is a rare condition that has been documented in association with viral, bacterial, fungal and parasitic infections as well as a wide spectrum of malignant neoplasms and autoimmune diseases. Whereas HPS is a known cause of anaemia in HIV infection, its occurrence is uncommon. Its occurrence in pregnancy is even rarer and very few such cases have been reported.

METHODS

Full clinical evaluation and investigations including bone marrow aspiration cytology were done to elucidate the cause of the anaemia.

RESULTS

Evaluation revealed severe anaemia, increased serum bilirubin HIV positivity and a low CD4 count. The final diagnosis confirmed the case to be haemophagocytic syndrome in pregnancy. A 31-year-old primigravida presented at 21 weeks of gestation with a two-week history of fever, jaundice and abdominal pain. She responded to treatment.

CONCLUSION

Although a rare condition, this case highlights the importance of a high index of suspicion for the syndrome in HIV positive pregnant women with persistent Coombs negative haemolytic anaemia. Full recovery could be expected following prompt institution of HAART and delivery.