Article ID Journal Published Year Pages File Type
5630179 Journal of Neuroimmunology 2017 4 Pages PDF
Abstract

•First report of hemophagocytic lymphohistiocytosis complicating neuromyelitis optica•Awareness of atypical HLH need to be raised, especially in patients with autoimmune disease•Flow cytometry for perforin is able to recognize common hypomorphic mutations like A91V.

Neuromyelitis optica is an autoimmune demyelinating inflammatory disease characterized by optic neuritis and myelitis with anti-aquaporin 4 antibodies. Hemophagocytic lymphohistiocytosis is a severe systemic inflammatory syndrome that can present in a genetic primary form or secondarily to infective, neoplastic or autoimmune diseases. Our case discusses the first reported case of atypical late-onset hemophagocytic lymphohistiocytosis in a patient with neuromyelitis optica, with multiple triggering factors and carrying the common A91V hypomorphic perforin mutation, that blurs the distinction between primary and secondary forms.

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