Hemophagocytic lymphohistiocytosis: What's new in old diagnostic and clinical criteria?
Acta Haematologica Polonica
; 53(1):19-25, 2022.
Article
in English
| EMBASE | ID: covidwho-1822565
ABSTRACT
Hemophagocytic lymphohistiocytosis (HLH) is a condition of overexpressed inflammatory response resulting in hypercytokinemia, macrophages infiltration and subsequent multiple organ failure. Without treatment, it leads to death. The main etiological factors include viral, bacterial and parasitic infections, malignancies and autoinflammatory diseases. The main clinical manifestations are high fever ≥38°C, lymphadenopathy, splenomegaly, and hepatomegaly. Central nervous system involvement occurs in 30-70% of cases. Less common symptoms include dyspnea, cough, arrhythmias, jaundice, peripheral edema, rashes, albinism and diarrhea. The picture of the disease seen in laboratory tests consists of duopenia, hypofibrinogenemia (<150 mg/dL) high D-dimers level, and hyperferritinemia. Other abnormalities include hypertriglyceridemia, elevated liver enzymes, hyperbilirubinemia, hypoalbuminemia and hyponatremia. Diagnostics include laboratory tests, histopathological examination, lumbar puncture, radiological imaging, functional test and genetic checking. It is important to rule out factors mimicking HLH. Some of the old, well-known criteria are of less relevance nowadays. The aim of the therapy is immunosuppressive, immunomodulatory and anti-cytokine treatment, using the HLH-2004 protocol. In secondary HLH, elimination of the causative agent is critical. In primary HLH, or relapse of secondary forms, allogeneic transplantation is the only curative treatment. The prognosis is uncertain.
allotransplantation; clinical feature; coronavirus disease 2019; cytology; diagnostic imaging; disease classification; Epstein Barr virus infection; genetic screening; hemophagocytic syndrome; histopathology; human; immunonutrition; immunosuppressive treatment; laboratory test; lumbar puncture; macrophage activation syndrome; pathophysiology; pediatric multisystem inflammatory syndrome; prognosis; review; risk factor
Full text:
Available
Collection:
Databases of international organizations
Database:
EMBASE
Type of study:
Prognostic study
Language:
English
Journal:
Acta Haematologica Polonica
Year:
2022
Document Type:
Article
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