Case Report
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jun 6, 2020; 8(11): 2364-2373
Published online Jun 6, 2020. doi: 10.12998/wjcc.v8.i11.2364
Hemophagocytic syndrome as a complication of acute pancreatitis: A case report
Chao-Qun Han, Xin-Ru Xie, Qin Zhang, Zhen Ding, Xiao-Hua Hou
Chao-Qun Han, Xin-Ru Xie, Zhen Ding, Xiao-Hua Hou, Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
Qin Zhang, Division of Pathology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
Author contributions: Han CQ performed the literature search and data extraction and drafted the manuscript; Xie XR collected the data; Zhang Q provided pathology results; Hou XH revised the manuscript for important intellectual content; Ding Z designed the study and edited the manuscript as corresponding author.
Supported by the National Natural Science Foundation of China, No. 81800467, No. 81974062, and No. 81770637.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Zhen Ding, MD, PhD, Doctor, Professor, Teacher, Chief Physician, Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1277, Jiefang Avenue, Wuhan 430022, Hubei Province, China. 2007xh0814@hust.edu.cn
Received: January 21, 2020
Peer-review started: February 14, 2020
First decision: April 9, 2020
Revised: April 17, 2020
Accepted: May 13, 2020
Article in press: May 13, 2020
Published online: June 6, 2020
Processing time: 115 Days and 2.4 Hours
Abstract
BACKGROUND

Haemophagocytic syndrome (HPS) is rarely seen in patients with acute pancreatitis (AP). HPS as a complication of AP in patients without any previous history has not been elucidated.

CASE SUMMARY

A 46-year-old man was admitted for symptom of persistent abdominal pain, nausea, and vomiting for 2 d after heavy drinking. During hospital stay, he suddenly developed skin rash and a secondary fever. The laboratory findings revealed progressive pancytopenia, abnormal hepatic tests, and elevation of serum triglyceride, ferritin, and lactate dehydrogenase levels. However, apparent bacterial or viral infections were not detected. He was also possibly related to autoimmune diseases because of positive expression of various autoimmune antibodies and no remarkable past history. Finally, the bone marrow examination showed a histiocytic reactive growth and prominent hemophagocytosis, which resulted in a diagnosis of HPS. Unexpectedly, the patient responded well to the immunosuppressive therapy.

CONCLUSION

HPS is a very rare extrapancreatic manifestation of AP. The diagnosis relies on bone marrow examination and immunosuppressive therapy is effective. For AP with skin changes, the possibility of HPS should be considered during clinical work.

Keywords: Haemophagocytic syndrome; Acute pancreatitis; Immunosuppressive therapy

Core tip: Haemophagocytic syndrome is a rare extrapancreatic manifestation of acute pancreatitis. We herein report the first such case to share our experience with its diagnosis and treatment. The patient responded well to the immunosuppressive therapy. Early diagnosis and treatment are crucial.