Dexamethasone
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Lack of efficacy: case report A 45-year-old man exhibited lack of effect of dexamethasone, indicated for haemophagocytic lymphohistiocytosis (HLH) syndrome. The man had fever and chills since two months, without any specific circadian patterns. At initial admission, the body temperature was 38°C. Additionally, there was splenomegaly in clinical examination, which was detected by ultrasound as huge splenomegaly and hepatomegaly. Both the kidneys had increased echo pattern with corticomedullary contrast, suggestive of acute tubular necrosis. Following further investigations, one of the proposed differential diagnoses was haemophagocytic syndrome. Dexamethasone 40 mg/day [route not stated] was prescribed. However, dexamethasone did not show life-saving effect. During admission, he developed generalised bleeding, which led to alveolar hemorrhage, resulting in death. Liver necropsy revealed many macrophages, and the diagnosis of HLH syndrome was established (based on high fever, splenomegaly, pancytopenia, high ferritin and high number of macrophages in necropsy). Kaveh V, et al. Death from hemophagocytic lymphohistiocytosis syndrome due to generalized hemorrhage. Journal of Advances in Medical and Biomedical Research 28: 803496978 111-115, No. 127, Apr 2020. Available from: URL: http://doi.org/10.30699/jambs.28.127.119
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Reactions 22 Aug 2020 No. 1818
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