https://doi.org/10.4081/monaldi.2023.2377

Hemophagocytic syndrome in a patient with long-term stable pulmonary sarcoidosis with progressive spleen and bone marrow lesion

Vol. 93 No. 4 (2023)
Submitted: July 21, 2022
Accepted: December 27, 2022
Published: January 11, 2023
pancytopenia, hemophagocytosis, splenomegaly, non-caseating granulomas
Abstract Views: 847
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Authors

Hazuki Fujimoto
https://orcid.org/0000-0001-7895-9359
Department of General Internal Medicine, Akashi Medical Center, Hyogo, Japan.
Yohei Kanzawa
kanzawa.youhei.26r@st.kyoto-u.ac.jp
https://orcid.org/0000-0003-2206-3785
Department of General Internal Medicine, Akashi Medical Center, Hyogo, Japan.
Hidemine Senba
Department of Pathology, Akashi Medical Center, Hyogo, Japan.
Tetsuo Washio
Department of Radiology, Akashi Medical Center, Hyogo, Japan.
Yukiko Kato
Department of General Internal Medicine, Akashi Medical Center, Hyogo, Japan.
Kei Kawano
https://orcid.org/0000-0003-1880-3082
Department of General Internal Medicine, Akashi Medical Center, Hyogo, Japan.
Shimpei Mizuki
Department of General Internal Medicine, Akashi Medical Center, Hyogo, Japan.
Jun Ohnishi
Department of General Internal Medicine, Akashi Medical Center, Hyogo, Japan.
Takahiro Nakajima
Department of General Internal Medicine, Akashi Medical Center, Hyogo, Japan.
Naoto Ishimaru
https://orcid.org/0000-0002-3034-7588
Department of General Internal Medicine, Akashi Medical Center, Hyogo, Japan.
Saori Kinami
Department of General Internal Medicine, Akashi Medical Center, Hyogo, Japan.

An 83-year-old woman with asymptomatic pulmonary sarcoidosis presented to our hospital with fever and malaise for three months. Abdominal CT showed splenomegaly, and bone marrow examination revealed non-caseating granulomas. Pancytopenia was diagnosed due to bone marrow and splenic lesions of sarcoidosis. Steroid pulses were administered, but the patient died without response to treatment. Pathological autopsy results showed non-caseating granulomas and hemophagocytosis in the spleen and bone marrow. This suggested hemophagocytic syndrome, which was not suspected before death, in addition to sarcoidosis. In patients with splenomegaly and pancytopenia with history of pulmonary sarcoidosis, hemophagocytic syndrome should be considered in differential diagnosis.

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How to Cite

Fujimoto, Hazuki, Yohei Kanzawa, Hidemine Senba, Tetsuo Washio, Yukiko Kato, Kei Kawano, Shimpei Mizuki, Jun Ohnishi, Takahiro Nakajima, Naoto Ishimaru, and Saori Kinami. 2023. “Hemophagocytic Syndrome in a Patient With Long-Term Stable Pulmonary Sarcoidosis With Progressive Spleen and Bone Marrow Lesion”. Monaldi Archives for Chest Disease 93 (4). https://doi.org/10.4081/monaldi.2023.2377.
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