Otsubo Keisuke, Fukumura Akiko, Hirayama Mariko, Morimoto Tsuyoshi, Kato Masahiko, Mochizuki Hiroyuki
Department of Pediatrics, Tokai University School of Medicine, Isehara, Japan.
Pediatr Int. 2016 May;58(5):390-393. doi: 10.1111/ped.12817. Epub 2016 Apr 14.
Hemophagocytic lymphohistiocytosis (HLH) is a hyperinflammatory condition resulting from an uncontrolled and ineffective immune response. Here, we report a case of HLH caused by disseminated herpes simplex virus (HSV)-1 infection. The patient was initially treated with prednisolone and high-dose acyclovir. Although liver enzymes, coagulation abnormalities, and inflammatory markers were remarkably improved, the platelet count remained low. Prednisolone was therefore switched to dexamethasone palmitate. Thereafter, the platelet count normalized. Inflammatory markers normalized 30 days after admission and serum HSV-DNA became undetectable on day 41. The patient was discharged on day 91 and no developmental delay was evident at 7 months of age. These findings suggest that dexamethasone palmitate is effective for neonatal HLH.
噬血细胞性淋巴组织细胞增生症（HLH）是一种由不受控制且无效的免疫反应导致的高炎症状态。在此，我们报告一例由播散性单纯疱疹病毒1型（HSV-1）感染引起的HLH病例。该患者最初接受泼尼松龙和高剂量阿昔洛韦治疗。尽管肝酶、凝血异常和炎症指标显著改善，但血小板计数仍低。因此，将泼尼松龙换为棕榈酸地塞米松。此后，血小板计数恢复正常。入院30天后炎症指标恢复正常，第41天时血清HSV-DNA检测不到。患者于第91天出院，7个月大时未发现发育迟缓。这些发现表明棕榈酸地塞米松对新生儿HLH有效。
