This paper reports one adult case presenting with headache and diplopia as initial symptoms of hemophagocytic syndrome (HPS), describing the diagnostic process and treatment outcomes, in order to improve the understanding of HPS complicated by nervous system involvement. A 55-year-old female adult case presented with headache and diplopia as initial symptoms followed by high fever was hospitalized in Department of Neurology, Renji Hospital, Shanghai Jiao Tong University School of Medicine. Admission laboratory tests revealed pancytopenia, abnormal liver function (elevated serum levels of alanine aminotransferase, aspartate aminotransferase, and lactate dehydrogenase), hypertriglyceridemia, hypofibrinogenemia and hyperferritinaemia. The results of bone marrow aspiration and biopsy showed decreased proliferation of nucleated bone marrow cells, reduction of all three hematopoietic cell lines, and hemophagocytosis of neutrophils and platelets, indicating the diagnosis of HPS. This case report suggests that when a patient presenting with headache, diplopia, fever, and reduction of peripheral whole blood cells should be highly suspected for the possibility of secondary HPS, and the early bone marrow aspiration and biopsy is the key to make a definite diagnosis.
Key words
Hemophagocytic syndrome /
Nervous system /
Headache /
Diplopia /
Adults
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