The first pediatric case of hemophagocytic lymphohistiocytosis secondary to Crimean-Congo haemorrhagic fever successfully treated with therapeutic plasma exchange accompanying ribavirin and intravenous immunoglobulin

GAYRETLİ AYDIN Z. G., YEŞİLBAŞ O., REİS G. P., GÜVEN B.

JOURNAL OF CLINICAL APHERESIS, vol.36, pp.780-784, 2021 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 36
  • Publication Date: 2021
  • Doi Number: 10.1002/jca.21915
  • Journal Name: JOURNAL OF CLINICAL APHERESIS
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE, MEDLINE
  • Page Numbers: pp.780-784
  • Keywords: Crimean-Congo hemorrhagic fever, hemophagocytic lymphohistiocytosis, pediatric, ribavirin, therapeutic plasma exchange, ACTIVATION SYNDROME, GUIDELINES
  • Karadeniz Technical University Affiliated: Yes

Abstract

Although Crimean-Congo hemorrhagic fever (CCHF) is mild and self-limited in children, some patients may develop excessive bleeding, massive liver necrosis, and multiple organ failure associated with secondary hemophagocytic lymphohistiocytosis (HLH) induced by cytokine storm. Treatment of CCHF is mainly symptomatic and supportive. The efficacy of ribavirin, which is the only antiviral drug in the treatment of CCHF, remains controversial. Although therapeutic plasma exchange (TPE) has been shown to beneficial in small case series with primary and secondary HLH, there is no pediatric patient with HLH secondary to CCHF treated with TPE in the literature. In this report, we describe the first pediatric patient who was successfully recovered from HLH secondary to CCHF with ribavirin, intravenous immunoglobulin, and TPE.