Effectiveness of therapeutic plasma exchange in a critically ill child with secondary hemophagocytic lymphohistiocytosis

Currently, the ASFA has not included TPE in the management of HLH but many cases reports have reported successful role of TPE in HLH. Here we are presenting a case in which HLH was managed successfully with TPE. Diagnosis of HLH is based on the HLH 2004 diagnostic criteria proposed by HLH society. T...

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Main Authors: Prashant Kumar Pandey, Esha Kaul, Nitin Agarwal, Shalendra Goel
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2019-01-01
Series:Asian Journal of Transfusion Science
Subjects:
Online Access:http://www.ajts.org/article.asp?issn=0973-6247;year=2019;volume=13;issue=2;spage=145;epage=147;aulast=Pandey
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author Prashant Kumar Pandey
Esha Kaul
Nitin Agarwal
Shalendra Goel
author_facet Prashant Kumar Pandey
Esha Kaul
Nitin Agarwal
Shalendra Goel
author_sort Prashant Kumar Pandey
collection DOAJ
description Currently, the ASFA has not included TPE in the management of HLH but many cases reports have reported successful role of TPE in HLH. Here we are presenting a case in which HLH was managed successfully with TPE. Diagnosis of HLH is based on the HLH 2004 diagnostic criteria proposed by HLH society. TPE was done using COM.TEC (Fresenius Kabi, Germany). Patient required three sessions of TPE. After three sessions of TPE patient's clinical condition improved remarkably and he was switched to IV Dexamethasone as maintenance treatment. One standard TPE procedure was 1.5 plasma volume exchanges. In view of deranged coagulation profile fresh frozen plasma was used as a replacement fluid. During follow up after one month of discharge, patient was absolutely normal. In developing countries like India, where infections are still a prime concern to the physicians, making an accurate diagnosis of HLH is a great concern. High suspicion, timely diagnosis and early start of TPE can be life saving in such patients.
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spelling doaj.art-a8b21a52fb3d4bd78d0501dc3aa91ad82022-12-22T03:20:56ZengWolters Kluwer Medknow PublicationsAsian Journal of Transfusion Science0973-62471998-35652019-01-0113214514710.4103/ajts.AJTS_45_18Effectiveness of therapeutic plasma exchange in a critically ill child with secondary hemophagocytic lymphohistiocytosisPrashant Kumar PandeyEsha KaulNitin AgarwalShalendra GoelCurrently, the ASFA has not included TPE in the management of HLH but many cases reports have reported successful role of TPE in HLH. Here we are presenting a case in which HLH was managed successfully with TPE. Diagnosis of HLH is based on the HLH 2004 diagnostic criteria proposed by HLH society. TPE was done using COM.TEC (Fresenius Kabi, Germany). Patient required three sessions of TPE. After three sessions of TPE patient's clinical condition improved remarkably and he was switched to IV Dexamethasone as maintenance treatment. One standard TPE procedure was 1.5 plasma volume exchanges. In view of deranged coagulation profile fresh frozen plasma was used as a replacement fluid. During follow up after one month of discharge, patient was absolutely normal. In developing countries like India, where infections are still a prime concern to the physicians, making an accurate diagnosis of HLH is a great concern. High suspicion, timely diagnosis and early start of TPE can be life saving in such patients.http://www.ajts.org/article.asp?issn=0973-6247;year=2019;volume=13;issue=2;spage=145;epage=147;aulast=Pandeyhemophagocytic lymphohistiocytosiscriteria 2004therapeutic plasma exchange
spellingShingle Prashant Kumar Pandey
Esha Kaul
Nitin Agarwal
Shalendra Goel
Effectiveness of therapeutic plasma exchange in a critically ill child with secondary hemophagocytic lymphohistiocytosis
Asian Journal of Transfusion Science
hemophagocytic lymphohistiocytosis
criteria 2004
therapeutic plasma exchange
title Effectiveness of therapeutic plasma exchange in a critically ill child with secondary hemophagocytic lymphohistiocytosis
title_full Effectiveness of therapeutic plasma exchange in a critically ill child with secondary hemophagocytic lymphohistiocytosis
title_fullStr Effectiveness of therapeutic plasma exchange in a critically ill child with secondary hemophagocytic lymphohistiocytosis
title_full_unstemmed Effectiveness of therapeutic plasma exchange in a critically ill child with secondary hemophagocytic lymphohistiocytosis
title_short Effectiveness of therapeutic plasma exchange in a critically ill child with secondary hemophagocytic lymphohistiocytosis
title_sort effectiveness of therapeutic plasma exchange in a critically ill child with secondary hemophagocytic lymphohistiocytosis
topic hemophagocytic lymphohistiocytosis
criteria 2004
therapeutic plasma exchange
url http://www.ajts.org/article.asp?issn=0973-6247;year=2019;volume=13;issue=2;spage=145;epage=147;aulast=Pandey
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AT nitinagarwal effectivenessoftherapeuticplasmaexchangeinacriticallyillchildwithsecondaryhemophagocyticlymphohistiocytosis
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