Fatal adenovirus serotype 21 infection associated with hemophagocytic lymphohistiocytosis and multiorgan failure

Tim Lahm, Helena N. Spartz, Dean A. Hawley, Diane S. Leland, Karen M. Wolf, Homer Twigg, Michael D. Ober

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Recent reports describe an increase in the incidence of fatal adenovirus infections. Several severe cases have been linked to adenovirus serotype 21. The exact etiology for this unexpectedly high mortality remains unknown. We report the case of a patient with severe adenovirus serotype 21 pneumonia resulting in hemophagocytic lymphohistiocytosis (HLH) with acute respiratory distress syndrome and rapidly progressive multiorgan dysfunction syndrome (MODS). HLH describes a cytokine storm due to uncontrolled accumulation of activated T-lymphocytes and activated histiocytes. This results in organ infiltration with these cells, and subsequent hemophagocytosis of erythrocytes, leukocytes and platelets. In its most severe form, HLH leads to a sepsis-like picture and MODS. The association between adenovirus 21 and HLH may at least in part explain the recently observed increase in incidence of fatal adenoviral infections. We suggest that HLH should be considered in cases of severe adenoviral infection. If HLH is present, aggressive treatment is warranted.

Original languageEnglish
Pages (from-to)223-225
Number of pages3
JournalRespiratory Medicine CME
Volume3
Issue number4
DOIs
StatePublished - 2010

Fingerprint

Hemophagocytic Lymphohistiocytosis
Adenoviridae
Infection
Adenoviridae Infections
Histiocytes
Incidence
Adult Respiratory Distress Syndrome
Serogroup
Sepsis
Pneumonia
Leukocytes
Blood Platelets
Erythrocytes
Cytokines
T-Lymphocytes
Mortality

Keywords

  • Cytokines
  • Granzyme
  • Hemophagocytic syndrome
  • Lymphocytes
  • Macrophage activation syndrome
  • Perforin
  • Shock

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

Fatal adenovirus serotype 21 infection associated with hemophagocytic lymphohistiocytosis and multiorgan failure. / Lahm, Tim; Spartz, Helena N.; Hawley, Dean A.; Leland, Diane S.; Wolf, Karen M.; Twigg, Homer; Ober, Michael D.

In: Respiratory Medicine CME, Vol. 3, No. 4, 2010, p. 223-225.

Research output: Contribution to journalArticle

Lahm, Tim ; Spartz, Helena N. ; Hawley, Dean A. ; Leland, Diane S. ; Wolf, Karen M. ; Twigg, Homer ; Ober, Michael D. / Fatal adenovirus serotype 21 infection associated with hemophagocytic lymphohistiocytosis and multiorgan failure. In: Respiratory Medicine CME. 2010 ; Vol. 3, No. 4. pp. 223-225.
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