PMC8597364_01
Evolution of leukocytes, neutrophils and CD4 T-lymphocytes. CD4: Cluster of differentiation 4; HLH: Hemophagocytic lymphohistiocytosis
RJME-62-1-279-fig1.jpg
PMC8597364_01_RJME-62-1-279-fig1.jpg
F1
CD4 T-lymphocytes number and neutrophil count remained low (Figure 1), with G-CSF having a prompt but brief favorable response, continuous administration of at least two doses per week being necessary.
Bone marrow aspirate showing lymphophagocytosis. May-Grunwald-Giemsa (MGG) staining, x1000
RJME-62-1-279-fig2.jpg
PMC8597364_01_RJME-62-1-279-fig2.jpg
F2
A bone marrow aspirate revealed granulocytic hypoplasia, pleomorphic lymphoid population, reactive macrophages (irregular nuclear shape, increased in volume, intranuclear vacuoles, eosinophilic cytoplasm), which presented hemophagocytosis and lymphocytosis (Figures 2 and 3) and, in association with fever, bicytopenia (neutrophilia and moderate normochromic normocytic anemia), hypofibrinogenemia and hypertriglyceridemia allowed the diagnosis of HLH secondary to HIV infection.
Bone marrow aspirate showing hemophagocytosis. MGG staining, x1000
RJME-62-1-279-fig3.jpg
PMC8597364_01_RJME-62-1-279-fig3.jpg
F3
A bone marrow aspirate revealed granulocytic hypoplasia, pleomorphic lymphoid population, reactive macrophages (irregular nuclear shape, increased in volume, intranuclear vacuoles, eosinophilic cytoplasm), which presented hemophagocytosis and lymphocytosis (Figures 2 and 3) and, in association with fever, bicytopenia (neutrophilia and moderate normochromic normocytic anemia), hypofibrinogenemia and hypertriglyceridemia allowed the diagnosis of HLH secondary to HIV infection.