A Case Report of Hemophagocytic Lymphohistiocytosis (HLH) - An Unusual Complication of Dengue Infection.

Autor:	Acharya S; Department of Medicine, Datta Meghe Institute of Medical Sciences, Wardha, IND.; Department of Medicine, Jawaharlal Nehru Medical College, Wardha, IND., Shukla S; Department of Pathology, Datta Meghe Institute of Medical Sciences, Wardha, IND.; Department of Pathology, Jawaharlal Nehru Medical College, Wardha, IND., Sontakke T; Department of Medicine, Datta Meghe Institute of Medical Sciences, Wardha, IND., Vs I; Department of Medicine, Datta Meghe Institute of Medical Science, Wardha, IND.; Department of Medicine, Jawaharlal Nehru Medical College, Wardha, IND., Bagga C; Department of Internal Medicine, Jawaharlal Nehru Medical College, Wardha, IND., Dronamraju S; Department of Medicine, Datta Meghe Institute of Medical Sciences, Wardha, IND.; Department of Medicine, Jawaharlal Nehru Medical College, Wardha, IND., Giri A; Department of Medicine, Datta Meghe Institute of Medical Science, Wardha, IND.; Department of Medicine, Jawaharlal Nehru Medical College, Wardha, IND.
Jazyk:	angličtina
Zdroj:	Cureus [Cureus] 2022 Jul 01; Vol. 14 (7), pp. e26504. Date of Electronic Publication: 2022 Jul 01 (Print Publication: 2022).
DOI:	10.7759/cureus.26504
Abstrakt:	Hemophagocytic lymphohistiocytosis (HLH) is an autoimmune phenomenon characterized by reactive hyperactivity of cytotoxic T cells and histiocytes, leading to hypercytokinemic injury to cells and organ system, which leads to multiorgan dysfunction and ultimate failure. Epstein-Barr virus (EBV) is most commonly associated with secondary HLH with high mortality, but increasing evidence suggests the association of the dengue virus. When associated with dengue infection, it carries a grave prognosis and correlates with the disease severity. Furthermore, it overlaps with dengue sepsis, so it can often be misdiagnosed as sepsis. Typically the patients have hyperferritinemia, hypertriglyceridemia, transaminitis, and marrow features suggestive of hemophagocytosis. The treatment is usually systemic corticosteroids, intravenous immunoglobulin, and chemotherapy with etoposide. We present a case of a 25-year-old male patient who had a dengue infection and further developed HLH with pulmonary infiltrates. Clinical suspicion alerted us to look for other evidence of HLH on the fourth day of admission, and appropriate investigations were done. Diagnosis of HLH was confirmed by HLH-2004, HScore criteria, and bone marrow aspirate examination. Treatment was given in the form of corticosteroids and chemotherapy along with other supportive measures. The patient responded to the line of management. Competing Interests: The authors have declared that no competing interests exist. (Copyright © 2022, Acharya et al.)
Databáze:	MEDLINE
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