Dengue associated haemophagocytic lymphohystiocytosis: An often-missed complication of a common infection

@#life-threatening condition causing multisystem involvementsuch as cytopenia, hepatosplenomegaly, and death. Dengueinfection is one of the leading causes of HLH. We reviewedthree cases of children at HRH Princess Maha ChakriSirindhorn Medical Center, Faculty of Medicine,Srinakharinwirot University, Nakhon Nayok, Thailand, withdengue fever who subsequently developed HLH, based onthe HLH-2004 diagnostic criteria. Following treatment withdexamethasone and intravenous immunoglobulin, there wasa dramatic response including defervescence andimprovement of cytopenia, hyperfibrinogenemia, andhyperferritinemia. Key features for diagnosis of denguefever complicated by HLH include a history of prolongedfever exceeding seven days, splenomegaly, and worseningcytopenia. Early recognition and treatment are crucial for asuccessful outcome.