García TMJ, Aguilar GÉS, Reyes GU, Vargas MME, Carreón GJM, Escalera AP, Quero HA, Fraga PJ, Reyes HKL, Murillo RC, Narváez AV

Language: Spanish
References: 12
Page: 39-43
PDF size: 328.87 Kb.

ABSTRACT

Hemophagocytic syndrome (HFS), also known as hemophagocytic lymphohistiocytosis, is a syndrome characterized by pathological immune activation that can occur primarily (associated with genetic mutations) or related to infections, neoplasms or autoimmune diseases. This report describes a 7-year-old male patient with HFS secondary to Salmonella Typhi infection. The clinical presentation included persistent fever, splenomegaly, cytopenias, and elevated ferritin levels, significantly increasing the H-score and suggesting a high diagnostic probability. The patient met the criteria of the HLH-2004 protocol, and treatment with dexamethasone, cyclosporine, and ciprofloxacin was initiated. Currently, the patient is stable, with pro- gressive reduction in ferritin levels and resolution of hepatomegaly and splenomegaly. The application of the diagnostic criteria for HFS, which consider clinical and analytical data (including a bone marrow aspirate), and the search for the triggering factor (infectious, oncological, rheumatological, metabolic), are key to establishing a targeted treatment, which Neutralize the trigger and stop hyperinflammation, thereby reducing mortality.

REFERENCES

1. Álfaro Mora Ráses. Aspectos relevantes sobreSalmonella sp en humanos. Rev Cub de Med GenInt. 2018; 34(3): 110-22.

2. Red Book: 2024. Report of the Committee on InfectiousDiseases, 33rd Ed. American Academyof Pediatrics, Salmonellosis; 2024: 742-49.

3. Secretaría de Salud. Boletín Epidemiológico delSistema Nacional de Vigilancia Epidemiológica[Internet]. Disponible en: https://www.gob.mx/salud/documentos/boletinepidemiologico-sistema-nacional-de-vigilancia-epidemiologica-sistema-unico-de-informacion-387843

4. D. Dávila Dupont, IR de la Peña López. Síndromehemofagocítico reporte de un caso y revisión dela literatura. Revista de la facultad de medicinade la UNAM. Medigraphic [Internet]. 2019, 62(2):15-21. Disponible en: https://www.medigraphic.com/cgi-bin/new/resumen.cgi?IDARTICULO=85834&id2=

5. Carreón GJM, Arce CD, Macías RSA, SánchezMN, Reyes GU, Quero HA, et al. Síndrome hemofagocíticosecundario a rickettsiosis. Experienciaen un Hospital Pediátrico de Sinaloa,México. Rev Latin Infect Pediatr. 2023; 36(2): 87-93. doi:10.35366/112108

6. Salgado CY, Valdez SC, MaIlin GY, Montano MY.Síndrome hemofagocítico neonatal. Reporte decaso. Rev Cien Med Pinard el Río. 2023; 27: P1.

7. Otorola BD, Troncoso LN, Álvarez CD, BahamondesML. Síndrome hemofagocítico, enfrentamientodiagnóstico y terapeútico actual. Revisión apartir de un caso relacionado a virus Epstein-Barr.Rev Med Chile. 2020; 48: 3712-80.

8. Jordan BM, Allen EC, Weitzman S, Filipovich HA.How I treat hemophagocytic limphohistiocytosis.Blood. 2011; 118(15): 4041-52.

9. Reyes HKL, Santos CLA, Reyes GU, Quero HA,López CG, Guerrero BM, et al. Síndrome linfohistiocíticohemofagocítico secundario a infecciónurinaria por Escherichia coli, reporte de caso. EnfInfec Microbiol. 2019; 39(1): 36-42.

10. Portes Ortiz JA, Fiesco Sepúlveda K, Medina RojasG. Síndrome hemofagocítico secundario ainfección por virus del dengue. Rev Hab de CienMed [Internet]. 2021; 20(6). Disponible en: https://revhabanera.sld.cu/index.php/rhab/article/view/4122

11. García Campaña D. Síndrome hemofagocítico enpediatría, reporte de un caso. Rev Ciencias Médicas[Internet]. 2021; 25(5): e5095. Disponible en:http://revcmpinar.sld.cu/index.php/publicaciones/article/view/5095

12. Astigarraga I, González GN, Allende LM, AlsinaL. Síndrome hemofagocíticos: la importancia deldiagnóstico y tratamiento precoces. Anales dePediatría. 2018; 89(2): 124-8.