Çocuk Sağlığı ve Hastalıkları Dergisi 2006 , Vol 49 , Num 4
Cranial MR and proton MR spectroscopy findings in hemophagocytic lymphohistiocytosis
M. Akif Özdemir1, Yasemin Altuner Torun2, Ali Yıkılmaz3, Musa Karakükcü4, Dilek Çoban5
1Erciyes Üniversitesi Tıp Fakültesi Pediatri Profesörü
2Erciyes Üniversitesi Tıp Fakültesi Pediatri Uzmanı
3Erciyes Üniversitesi Tıp Fakültesi Pediatrik Radyoloji Uzmanı
4Erciyes Üniversitesi Tıp Fakültesi Pediatri Yardımcı
5Erciyes Üniversitesi Tıp Fakültesi Pediatri Araştırma Görevlisi
Özdemir MA, Altuner Torun Y, Yıkılmaz A, Karakükcü M, Çoban D. (Department of Pediatrics and Radiology, Erciyes University of Medicine, Kayseri, Turkey). Cranial MR and proton MR spectroscopy findings in hemophagocytic lymphohistiocytosis. Çocuk Sağlığı ve Hastalıkları Dergisi 2006; 49: 307-311.

Hemophagocytic lymphohistiocytosis (HLH) is a nonmalignant disorder of immune regulation, with overproduction of cytokines and diminished immune surveillance. Symptoms are nonspecific and may affect multiple organs, including the central nervous system (CNS). Seizures, focal neurologic deficits, and gait abnormalities are the most common neurologic manifestations. Neuroimaging findings have been described in case reports and small series; however, magnetic resonance spectroscopy (MRS) findings have not been described extensively. We report a 19-month-old boy with HLH with CNS involvement. Brain MR imaging basically revealed non-specific confluent white-matter involvement. On MRS major metabolite ratios were found as: NAA(N-acetylaspartate)/Cho(choline) 1.85, NAA/Cre(creatine) 2.40, and Cho/ Cre 1.29, which did not statistically differ from the control group (p>0.05). This presence of lactate indicates that the normal cellular oxidative respiration is no longer in effect, and that carbohydrate catabolism is taking place. MRS findings has been reported in one case before. Herein, we report the abnormal lactate peak that have been shown for the first time with MRS in HLH. Anahtar Kelimeler : kranial MR, hemofagositik lenfohistiositoz, proton MR spektroskopi, cranial MR, hemophagocytic lymphohistiocytosis, proton MR spectroscopy

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