Successful Recovery from Severe Fever with Thrombocytopenia Syndrome and Hemophagocytic Lymphohistiocytosis with Standard Treatment and a Calcium Channel Blocker of Nicardipine Hydrochloride: A Case Report

Nao Yamauchi; Takashi Hongo; Manri Kawakami; Kyosuke Inoguchi; Syunsuke Oguni; Noriya Momoki; Akiko Ueno; Fusao Ikeda; Shinichi Fujioka; Kazuhide Yamamoto

doi:10.2169/internalmedicine.9052-21

This article has now been updated. Please use the final version.

Successful Recovery from Severe Fever with Thrombocytopenia Syndrome and Hemophagocytic Lymphohistiocytosis with Standard Treatment and a Calcium Channel Blocker of Nicardipine Hydrochloride: A Case Report

Nao Yamauchi, Takashi Hongo, Manri Kawakami, Kyosuke Inoguchi, Syunsuke Oguni, Noriya Momoki, Akiko Ueno, Fusao Ikeda, Shinichi Fujioka, Kazuhide Yamamoto

Author information

Nao Yamauchi
Internal Medicine Department, Okayama Saiseikai General Hospital, Japan
Takashi Hongo
Emergency Department, Okayama Saiseikai General Hospital, Japan
Department of Emergency, Critical Care, and Disaster Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Japan
Manri Kawakami
Internal Medicine Department, Okayama Saiseikai General Hospital, Japan
Kyosuke Inoguchi
Internal Medicine Department, Okayama Saiseikai General Hospital, Japan
Syunsuke Oguni
Internal Medicine Department, Okayama Saiseikai General Hospital, Japan
Noriya Momoki
Internal Medicine Department, Okayama Saiseikai General Hospital, Japan
Akiko Ueno
Internal Medicine Department, Okayama Saiseikai General Hospital, Japan
Fusao Ikeda
Internal Medicine Department, Okayama Saiseikai General Hospital, Japan
Shinichi Fujioka
Internal Medicine Department, Okayama Saiseikai General Hospital, Japan
Kazuhide Yamamoto
Internal Medicine Department, Okayama Saiseikai General Hospital, Japan

Keywords: severe fever with thrombocytopenia syndrome, hemophagocytic lymphohistiocytosis, calcium channel blocker

JOURNAL OPEN ACCESS Advance online publication

Article ID: 9052-21

DOI https://doi.org/10.2169/internalmedicine.9052-21

The final version of this article is now available: Vol. 62 (2023), No. 9 pp. 1365-1369

Details

Abstract

A 67-year-old man was admitted to our hospital with a high fever. Laboratory tests revealed leukopenia, thrombocytopenia, liver dysfunction, rhabdomyolysis, and hyperferritinemia. He was diagnosed with severe fever with thrombocytopenia syndrome (SFTS) complicated by hemophagocytic lymphohistiocytosis and treated with steroid therapy, intravenous calcium channel blocker (CCB), and supportive care, without favipiravir. Serum levels of ferritin and soluble interleukin 2 receptor (sIL2R) were markedly elevated on Day 3 after admission and decreased thereafter, while an SFTS viral load of 6.8×10⁴ copies/μL was detected on Day 2, increasing to 2.9×10⁵ copies/μL on Day 6. Serum ferritin and sIL2R levels may be better indicators of mortality than the SFTS viral load, and CCBs may have a therapeutic effect.

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