Kuzmanovic Milos, Pasic Srdjan, Prijic Sergej, Jovanovic Ankica, Kosutic Jovan
Department of Hematooncology, Mother and Child Health Institute, Dr Vukan Cupic, School of Medicine, University of Belgrade, Belgrade, Serbia.
J Pediatr Hematol Oncol. 2012 Aug;34(6):453-6. doi: 10.1097/MPH.0b013e318257a4cb.
An association between hemophagocytic lymphohistiocytosis (HLH) and severe transient left ventricular (LV) hypertrophy has not been described to date. Possible explanations, including etoposide toxicity, are discussed.
A 2-month-old male infant with HLH was treated according to the HLH-2004 protocol. Initial cardiac evaluation was within normal limits. During the second month of therapy, a heart murmur was discovered; electrocardiogram demonstrated signs of LV hypertrophy, and echocardiogram confirmed the presence of thickness of LV walls. This complication was transient: clinical findings, echocardiogram, and electrocardiogram recorded 6 months afterward were all within normal limits.
The case suggests the need for close echocardiographic monitoring during HLH treatment.
