Tuberculosis-associated hemophagocytic lymphohistiocytosis in an umbilical cord blood transplant recipient

Abstract

Background: Hemophagocytic lymphohistiocytosis (HLH) is a rare and potentially fatal condition that can be primary or secondary. Secondary HLH due to Mycobacterium tuberculosis (TB) is uncommon. We report a case of tuberculosis-associated HLH in an umbilical cord blood transplant (UCBT) recipient and discuss its clinical characteristics and challenges.

Methods: Hematologic investigations, bone marrow aspirates, Xpert MTB/RIF test of TB with peripheral blood were performed. Immune modulation with anti-TB therapy was initiated.

Results: Subsequent treatment with anti-TB treatment resulted rapid clinical response and disease remission.

Conclusion: It is important to consider TB as one of the underlying cause of HLH in high-risk patients, particularly those in immunodeficient states. Early diagnosis and treatment can improve the survival rates of patients with tuberculosis-associated HLH.

Keywords: Hemophagocytic lymphohistiocytosis; Tuberculosis; Umbilical cord blood transplant.