Secondary hemophagocytic lymphohistiocytosis (HLH) from a presumed brown recluse spider bite

J Clin Immunol. 2014 Jul;34(5):544-7. doi: 10.1007/s10875-014-0036-1. Epub 2014 Apr 16.

Abstract

Systemic loxoscelism is a rare complication after Loxosceles reclusa (brown recluse spider) envenomation. Loxosceles venom contains pro-inflammatory proteins, which have been shown to be elevated in patients with hemophagocytic lymph histiocytosis. We present a case of a 10-year-old male that developed presumed systemic loxoscelism, secondary hemophagocytic lymphohistiocytosis with hepatic dysfunction and renal failure. He was treated with dexamethasone and made a full recovery.

MeSH terms

  • Animals
  • Brown Recluse Spider*
  • Child
  • Dexamethasone / therapeutic use
  • Glucocorticoids / therapeutic use
  • Hepatic Insufficiency / drug therapy
  • Hepatic Insufficiency / etiology
  • Hepatic Insufficiency / immunology*
  • Hepatic Insufficiency / pathology
  • Humans
  • Insect Bites and Stings / complications
  • Insect Bites and Stings / drug therapy
  • Insect Bites and Stings / immunology*
  • Insect Bites and Stings / pathology
  • Lymphohistiocytosis, Hemophagocytic / drug therapy
  • Lymphohistiocytosis, Hemophagocytic / etiology
  • Lymphohistiocytosis, Hemophagocytic / immunology*
  • Lymphohistiocytosis, Hemophagocytic / pathology
  • Male
  • Phosphoric Diester Hydrolases / immunology*
  • Renal Insufficiency / drug therapy
  • Renal Insufficiency / etiology
  • Renal Insufficiency / immunology*
  • Renal Insufficiency / pathology
  • Spider Venoms / immunology*
  • Treatment Outcome

Substances

  • Glucocorticoids
  • Spider Venoms
  • loxosceles venom
  • Dexamethasone
  • Phosphoric Diester Hydrolases