J Pediatr Infect Dis 2016; 11(04): 136-140
DOI: 10.1055/s-0036-1597924
Case Report
Georg Thieme Verlag KG Stuttgart · New York

Aseptic Meningitis and Infection-Associated Hemophagocytic Lymphohistiocytosis—Rare Complications of Hepatitis A Virus İnfection

Suman Das
1   Department of Pediatric Medicine, Dr. B. C. Roy Post Graduate Institute of Pediatric Sciences, Kolkata, West Bengal, India
,
Anish Chatterjee
1   Department of Pediatric Medicine, Dr. B. C. Roy Post Graduate Institute of Pediatric Sciences, Kolkata, West Bengal, India
,
Mala Bhattacharya
1   Department of Pediatric Medicine, Dr. B. C. Roy Post Graduate Institute of Pediatric Sciences, Kolkata, West Bengal, India
,
Suprit Basu
1   Department of Pediatric Medicine, Dr. B. C. Roy Post Graduate Institute of Pediatric Sciences, Kolkata, West Bengal, India
,
Subhajit Bhakta
1   Department of Pediatric Medicine, Dr. B. C. Roy Post Graduate Institute of Pediatric Sciences, Kolkata, West Bengal, India
,
Soumalya Kundu
1   Department of Pediatric Medicine, Dr. B. C. Roy Post Graduate Institute of Pediatric Sciences, Kolkata, West Bengal, India
,
Nazir Abdul Wasim
2   Department of Pathology, Dr. B. C. Roy Post Graduate Institute of Pediatric Sciences, Kolkata, West Bengal, India
,
Arijit Majumdar
2   Department of Pathology, Dr. B. C. Roy Post Graduate Institute of Pediatric Sciences, Kolkata, West Bengal, India
› Author Affiliations
Further Information

Publication History

18 September 2016

25 October 2016

Publication Date:
29 December 2016 (online)

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Abstract

Case 1: An 8-year-old girl with a prodrome of fever and headache presented with generalized tonic clonic seizures. She had florid meningeal signs. Laboratory investigations revealed elevated liver enzymes. Cerebrospinal fluid had pleocytosis and elevated protein. Immunoglobulin M antibody against hepatitis A virus (HAV) was positive in serum. She recovered without sequelae.

Case 2: A 10-year-old girl with HAV infection developed progressive pancytopenia, coagulopathy, and worsening liver function. She fulfilled the 2009 diagnostic criteria of hemophagocytic lymphohistiocytosis (HLH). She had spontaneous resolution of HLH without immunosuppressive therapy.

Central nervous system involvements of HAV usually resolve without sequelae. HLH following hepatitis A is being increasingly reported and may resolve spontaneously.