[Hemophagocytic syndrome as primary manifestation in a patient with systemic lupus erythematosus after parturition]

Nihon Rinsho Meneki Gakkai Kaishi. 2009 Feb;32(1):66-70. doi: 10.2177/jsci.32.66.
[Article in Japanese]

Abstract

A 33-year-old woman presented with fever, malar rash, lymphadenopathy and pancytopenia 3 weeks after parturition. Serum C3 level was decreased and antinuclear antibody, anti-dsDNA antibody and anti-SS-A antibody were positive. Serum ferritin level was elevated (3454 ng/ml), and bone marrow aspirate revealed hemophagocytosis. She was diagnosed having systemic lupus erythematosus (SLE) associated with hemophagocytic syndrome (HPS). Oral prednisolone (55 mg/day) was initiated. Clinical manifestations and pancytopenia were improved and serum ferritin level was decreased. However, elevated anti-dsDNA antibody titer and reduced C3 level continued for a month after steroid therapy. The additional therapy of tacrolimus (3 mg/day) improved clinical and laboratory findings. This is a rare SLE case associated with HPS as primary manifestation after parturition.

Publication types

  • Case Reports
  • English Abstract
  • Review

MeSH terms

  • Adult
  • Female
  • Humans
  • Lupus Erythematosus, Systemic / complications*
  • Lymphohistiocytosis, Hemophagocytic / etiology*
  • Pregnancy
  • Puerperal Disorders*