Macrophages activation syndrome in patients infested with parasites about 3 cases with different outcomes

Full text loading... Abstract Hemophagocytic syndrome (HPS) also known as macrophage activation syndrome (MAS) is a rare and life-threatening condition characterized by a hyperinflammatory response, leading to the uncontrolled activation of macrophages and the subsequent hemophagocytosis of erythrocytes, leukocytes, and platelets. This can result in cytopenias, organomegaly, and multiorgan failure. The list of infectious agents that predispose to hemophagocytic syndrome has expanded since the first description of infection- associated hemophagocytosis (IAHS). Macrophage activation, bacterial or viral infections, parasite infestations, or malignancy can all result in the development of a lymphohistiocytic proliferation with hemophagocytosis that result from a defect in the NK cells and cytotoxic T cells usual cytolytic function. The pathogenesis of HPS in the context of parasite is not yet fully understood, but it is thought to be related to an imbalance in the immune response to the parasite. Visceral leishmaniasis (VL), also known as kala-azar, is a severe and potentially fatal parasitic disease caused by protozoa of the Leishmania genus. It is characterized by irregular bouts of fever, weight loss, hepatosplenomegaly, and anemia. One of the complications associated with this disease is HPS. Malaria is a worldwide problem. Plasmodium falciparum infection, particularly if the diagnosis wasn't at time, may result in a multi-organ failure. In the literature, Plasmodium falciparum infection was rarely cited as the root cause of HPS. In this article, we report 3 cases of parasite infestations complicated with MAS. We illustrate the clinical manifestations, diagnostic challenges, and management of this severe condition. Additionally we provide a comprehensive review of the current understanding of MAS in parasite, with a focus on the epidemiology, clinical manifestations, pathophysiology, diagnosis, and treatment options. Furthermore, we aim to discuss the latest advancements in research and the potential for new therapeutic approaches. By presenting those cases reports and enhancing our knowledge on this severe complication, we hope to contribute to the development of improved diagnostic tools and treatment strategies, ultimately reducing the morbidity and mortality associated with MAS patients, particularly I infested with parasite. - Received: - Version Posted: