Case report : Cytokine hemoadsorption in a case of hemophagocytic lymphohistiocytosis secondary to extranodal NK/T-cell lymphoma
Ruiz-Rodriguez, Juan Carlos (Universitat Autònoma de Barcelona. Departament de Medicina)
Chiscano-Camón, Luis (Universitat Autònoma de Barcelona. Departament de Medicina)
Ruiz-Sanmartin, Adolf (Universitat Autònoma de Barcelona. Departament de Medicina)
Palmada, Clara (Hospital Universitari Vall d'Hebron)
Bajaña, Iván (Hospital Universitari Vall d'Hebron)
Iacoboni, Gloria (Vall d'Hebron Institut d'Oncologia)
Bonilla, Camilo (Hospital Universitari Vall d'Hebron)
García-Roche, Alejandra (Hospital Universitari Vall d'Hebron)
Paola Plata-Menchaca, Erika (Hospital Universitari Vall d'Hebron)
Maldonado, Carolina (Hospital Universitari Vall d'Hebron)
Pérez-Carrasco, Marcos (Hospital Universitari Vall d'Hebron)
Martinez-Gallo, Mónica (Universitat Autònoma de Barcelona. Departament de Biologia Cel·lular, de Fisiologia i d'Immunologia)
Franco-Jarava, Clara (Hospital Universitari Vall d'Hebron)
Hernández-González, Manuel (Universitat Autònoma de Barcelona. Departament de Biologia Cel·lular, de Fisiologia i d'Immunologia)
Ferrer, Ricard (Universitat Autònoma de Barcelona. Departament de Medicina)

Date:	2022
Abstract:	We discuss a single case of Hemophagocytic lymphohistiocytosis (HLH) due to NK-type non-Hodgkin lymphoma and Epstein-Barr virus reactivation with multiorgan dysfunction and distributive shock in which we performed cytokine hemoadsorption with Cytosorb ®. A full microbiological panel was carried out, including screening for imported disease, standard serologies and cultures for bacterial and fungal infection. A liver biopsy and bone marrow aspirate were performed, confirming the diagnosis. The patients fulfilled the HLH-2004 diagnostic criteria, and according to the 2018 Consensus Statements by the HLH Steering Committee of the Histiocyte Society, dexamethasone and etoposide were started. There was an associated hypercytokinemia and, due to refractory distributive shock, rescue therapy with cytokine hemoadsorption was performed during 24 h (within day 2 and 3 from ICU admission). After starting this procedure, rapid hemodynamic control was achieved with a significant reduction in vasopressor support requirements. This case report highlights that cytokine hemoadsorption can be an effective since rapid decrease in IL-10 levels and a significant hemodynamic improvement was achieved.
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Hemophagocytic lymphohistiocytosis ; Cytokine storm ; Multiorgan dysfunction ; Cytokine hemoadsorption ; Shock
Published in:	Frontiers in Medicine, Vol. 9 (august 2022) , ISSN 2296-858X

DOI: 10.3389/fmed.2022.925751
PMID: 36045925

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