case_images: PMC11003789_01
case_images: (a, b) High-power micrographs taken of the first bone marrow core biopsy done at the community hospital. Note: macrophages with ingested erythrocytes (arrows).
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case_images: PMC11003789_01_CRIHEM2024-6964818.001.jpg
case_images: fig1
case_images: HLH (at the time, the patient met four of eight of diagnostic criteria and an HScore of 244 (99% probability of hemophagocytic syndrome), see Table 1 for details), the patient underwent a bone marrow aspirate and biopsy, which revealed a normocellular marrow with rare cells exhibiting hemophagocytosis (see Figure 1). However, it was the opinion of the treating hematologist that the bone marrow aspirate evidence was not fully convincing of a reactive hemophagocytic syndrome.
case_images: Pertinent biochemical results over the course of hospitalization.
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case_images: fig2
case_images: She remained afebrile with improving pancytopenia, normalizing ferritin, and decreasing CMV serum viral load (see Figure 2).