November 4, 2011
School of Medicine, Kochi
 

Dr. Balaji Natarajan, intern of the 2006 MBBS batch from the Amrita School of Medicine won the first prize for case presentation at OSMECON 2011.
 

Organized jointly by Osmania Medical College and International Medical Journal of Students’ Research [IMJSR], OSMECON included not only research paper and poster presentations but also case presentations, medical quiz and a seminar on research methodologies.
 

Dr. Balaji prize-winning case studied primary hemophagocytic syndrome, also known as hemophagocytic lymphohistiocytosis (HLH).
 

There are defense cells in our body called macrophages that attack pathogens. In very rare cases, they may start attacking the body’s blood cells and bone marrow cells, instead, causing HLH.
 

“I presented a case of idiopathic hemophagocytic syndrome in an adult that I encountered during my rotational posting in the Department of General Medicine,” reported Dr. Balaji.
 

“Because of the rarity of this condition and its nonspecific presentation, not many clinicians are aware of it,” he added.
 

In his case presentation, Dr. Balaji introduced the internationally-accepted diagnostic criteria for HLH.
 

“This condition typically presents as a fever that does respond to antibiotics, enlarged liver and spleen, falling blood count along with neurological conditions such as seizures and cranial nerve palsies,” he described.
 

He also listed important clinical and lab parameters a doctor should examine in every case where fever is present with low blood count and the cause is not clearly evident.
 

“Important lab findings are elevated ferritin and triglycerides, along with deranged liver function tests and hemophagocytic activity in the bone marrow. Treatment for this condition is early aggressive immunosuppression,” he outlined.
 

“A delay in diagnosis and treatment can lead to poor prognosis and high mortality rates. Death in most cases is due to multi-organ failure,” cautioned the doctor.
 

Dr. Balaji’s case presentation was selected as the best from among 45 case presentations at the medical convention and conference that was meant to inculcate the spirit of research and case development among medical students.
 

Dr. Balaji expressed his sincere gratitude to his teachers at the Amrita Department of General Medicine. “I would like to thank Dr. Ganapathi Rao, the Head of the Department,” he said. “Special thanks also to Drs. Sharma, Jacob, Vasanth, Velayuthan and Priya for their constant support and encouragement.”