The Diagnostic Significance of Various Laboratory Findings in Hemophagocytic Lymphohistiocytosis: A Receiver Operating Characteristic Curve Analysis / 대한소아혈액종양학회지

ABSTRACT

PURPOSE: The clinical findings of almost all of the hemophagocytic lymphohistiocytosis (HLH) patients are not significant. Early enforcement of bone marrow study for quicker detection of laboratory abnormalities in routine laboratory test, which is perfomed in febrile patients, is critical for early diagnosis of HLH. In this study, we tried to elucidate more significant laboratory test for the early diagnosis of HLH. METHODS: The study group and control group consisted of 13 HLH patients, and 46 febrile patients with causes like fever of unknown origin, kawasaki disease or acute lymphoblastic leukemia, respectively. Receiver operating characteristic (ROC) curve analysis of various laboratory findings of hyperpyrexic patients on the first day of admission were performed. RESULTS: The total WBC count, platelet count, serum triglyceride, serum transaminase, and serum ferritin revealed statistically significant differences between the study and the control group (P< 0.05). The ROC curve analysis revealed that serum triglyceride was the most efficient test for the differential diagnosis between HLH and febrile patients with other causes. And the serum transaminase, triglyceride and ferritin revealed a statistically significant difference between the study and the leukemia patients group (P< 0.05). The ROC curve analysis revealed that serum transaminase was the most efficient test for differential diagnosis between HLH and acute leukemia. CONCLUSION: In patients with persistent hyperpyrexia, the elevated serum triglyceride level is an important clue for the early diagnosis of HLH. In patient with persistent hyperpyrexia, and abnormal CBC findings, the elevated serum transaminase level is an important clue for the early diagnosis of HLH.