Clinically Mild Encephalitis/Encephalopathy With a Reversible Splenial Lesion Accompanied by Epstein-Barr Virus Hemophagocytic Lymphohistiocytosis: A Case Report and Review of the Literature

J Pediatr Hematol Oncol. 2017 Mar;39(2):e92-e96. doi: 10.1097/MPH.0000000000000708.

Abstract

Central nervous system involvement in hemophagocytic lymphohistiocytosis (HLH) is associated with a poor outcome. For such patients, it is unknown whether more aggressive therapies, such as intrathecal methotrexate or hydrocortisone, are inevitably required. We present a very rare case of 3-year-old Japanese girl who developed mild encephalitis/encephalopathy with a reversible splenial lesion, accompanied by Epstein-Barr virus-associated HLH, and review previous similar reports. Our case and previous reports suggest that mild encephalitis/encephalopathy with a reversible splenial lesion accompanied by Epstein-Barr virus-associated HLH has a relatively good prognosis, even in the absence of intrathecal treatments.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Bone Marrow / pathology
  • Corpus Callosum / diagnostic imaging
  • Corpus Callosum / pathology*
  • Cyclosporine / therapeutic use
  • Delirium / etiology
  • Dexamethasone / analogs & derivatives
  • Dexamethasone / therapeutic use
  • Diffusion Magnetic Resonance Imaging
  • Drug Therapy, Combination
  • Encephalitis / diagnostic imaging
  • Encephalitis / drug therapy
  • Encephalitis / etiology*
  • Epstein-Barr Virus Infections / complications*
  • Epstein-Barr Virus Infections / diagnostic imaging
  • Etoposide / therapeutic use
  • Humans
  • Hyponatremia / etiology
  • Lymphohistiocytosis, Hemophagocytic / complications*
  • Lymphohistiocytosis, Hemophagocytic / diagnostic imaging
  • Lymphohistiocytosis, Hemophagocytic / drug therapy
  • Lymphohistiocytosis, Hemophagocytic / virology
  • Methylprednisolone / administration & dosage
  • Methylprednisolone / therapeutic use
  • Neuroimaging
  • Prognosis
  • Pulse Therapy, Drug

Substances

  • Etoposide
  • Dexamethasone
  • Cyclosporine
  • Methylprednisolone