Hemophagocytic syndrome causing complete bone marrow failure. Report of an extreme case of a reactive histiocytic disorder.

The hemophagocytic syndrome is a reactive disorder of the mononuclear phagocytic system. Most of the cases are rare complications of common infectious and neoplastic diseases, although there may be an underlying immune disorder predisposing to this syndrome. We report a case in association with immune thrombocytopenia and hemolytic anemia (Evans' syndrome). The hemophagocytic reaction appeared after a bacterial infection of the urinary tract and presented with abrupt pancytopenia and complete hemopoietic failure. We discuss the possible mechanisms of bone marrow failure related with the hemophagocytic syndrome.