case_images: PMC7803163_01
case_images: Graphs showing the variation of the mean count of each bone marrow lineage as a function of time. (a) Mean white blood cell count (x1000 cells/muL) over time. Leukocytosis was noted since admission with no significant drop in white blood cell count observed during hospitalization. (b) Variation of mean hemoglobin level (g/dL) over time with acute drop in hemoglobin level observed within 3 days of admission. (c) Variation of mean platelet count (x1000 platelets/muL) over time showing a significant decrease of platelet count within 3 days of admission.
case_images: CRIHEM2020-8833196.001.jpg
case_images: PMC7803163_01_CRIHEM2020-8833196.001.jpg
case_images: fig1
case_images: Her laboratory studies revealed worsening thrombocytopenia (Figure 1), hyponatremia, and acute kidney injury.
case_images: Bone marrow biopsy specimen. Immunopathology reveals positive staining for CD163, indicating moderately increased number of macrophages, some of them with hemophagocytosis.
case_images: CRIHEM2020-8833196.002.jpg
case_images: PMC7803163_01_CRIHEM2020-8833196.002.jpg
case_images: fig2
case_images: After her death, the hemopathology report of the bone marrow aspirate showed cellular bone marrow (20 to 40%) with trilineage maturing hematopoiesis with the presence of hemophagocytosis and decreased iron stores (Figures 2 and 3). 5 out of 8 criteria for the diagnosis of HLH have therefore been met.
case_images: Microscopic analysis of a peripheral smear specimen with hematoxylin and eosin staining revealing the presence of macrophages with hemophagocytosis.
case_images: CRIHEM2020-8833196.003.jpg
case_images: PMC7803163_01_CRIHEM2020-8833196.003.jpg
case_images: fig3
case_images: After her death, the hemopathology report of the bone marrow aspirate showed cellular bone marrow (20 to 40%) with trilineage maturing hematopoiesis with the presence of hemophagocytosis and decreased iron stores (Figures 2 and 3). 5 out of 8 criteria for the diagnosis of HLH have therefore been met.