RESUMEN
A 16-year-old girl presented to her primary care physician with a one-month history of decreased appetite and abdominal pain. She had normal bowel movements and no vomiting, but her periumbilical pain limited her ability to finish most meals. She had gradual weight loss over the previous 2 years, and during the previous 4 years, she intermittently received counseling for depression after the loss of her mother. Her initial physical examination and laboratory evaluation were unremarkable. She was referred to a nutritionist, adolescent medicine, and pediatric gastroenterology. Her presentation evolved over time, which ultimately led to a definitive diagnosis.
Asunto(s)
Dolor Abdominal/diagnóstico , Apetito/fisiología , Enfermedad de Crohn/diagnóstico , Trastornos de Alimentación y de la Ingestión de Alimentos/diagnóstico , Pérdida de Peso/fisiología , Dolor Abdominal/etiología , Dolor Abdominal/metabolismo , Adolescente , Enfermedad de Crohn/complicaciones , Enfermedad de Crohn/metabolismo , Diagnóstico Diferencial , Trastornos de Alimentación y de la Ingestión de Alimentos/etiología , Trastornos de Alimentación y de la Ingestión de Alimentos/metabolismo , Femenino , Humanos , Complejo de Antígeno L1 de Leucocito/metabolismoRESUMEN
Secondary hemophagocytic lymphohistiocytosis (sHLH) is a rare hyperinflammatory disorder caused by an aberrant immune response to a number of infectious or inflammatory conditions. Successful treatment of this potentially fatal condition requires early recognition and prompt therapy directed at the underlying trigger. In this report, we describe the clinical presentation, diagnostic findings, management, and outcome of a child with Lemierre's syndrome-associated sHLH. This is the first reported association of these 2 rare conditions and expands the number of known triggers for sHLH.