Recurrent viral associated hemophagocytic syndrome in a child with Langerhans cell histiocytosis

Langerhans cell histiocytosis (LCH) with subsequent viral-associated hemoph agocytic syndrome (VAHS) or secondary hemophagocytic lymphohistiocytosis (H LH) is extremely rare. A 15-month-old girl with disseminated LCH experience d three episodes of VAHS during maintenance therapy. Viral infection, with influenza A, herpes simplex, and adenovirus, respectively, was documented a t each episode. She recovered each time after interruption of maintenance t herapy. The occurrence of fever and pancytopenia in patients with chemother apy-treated LCH can be associated with VAHS and not with relapsing LCH.