Haemophagocytic lymphohistiocytosis secondary to dengue fever: a case report

Upon arrival, he was alert with normal Glasgow Coma Scale score, blood pressure 126/82 mm Hg, pulse rate 126 beats per minute and temperature 37.7°C. Examination revealed jaundiced, cold peripheries, poor pulse volume, and a capillary refill time [greater than]2 s. Respiratory examination showed cre...

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Bibliographic Details
Published in:Hong Kong medical journal = Xianggang yi xue za zhi 2021-08, Vol.27 (4), p.287
Main Authors: Cheo, S W, Abdul Rashid, W N F A, Ho, C V, Ahmad Akhbar, R Z, Low, Q J, Rajahram, G S
Format: Article
Language:English
Subjects:
Biopsy
Bone marrow
Dehydrogenases
Dengue - complications
Dengue fever
Hemodialysis
Hospitals
Humans
Immunoglobulins
Infections
Internal medicine
Liver
Lymphohistiocytosis, Hemophagocytic - etiology
Mortality
Patients
Tropical diseases
Viral infections
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Summary:Upon arrival, he was alert with normal Glasgow Coma Scale score, blood pressure 126/82 mm Hg, pulse rate 126 beats per minute and temperature 37.7°C. Examination revealed jaundiced, cold peripheries, poor pulse volume, and a capillary refill time [greater than]2 s. Respiratory examination showed crepitations over the lung bases bilaterally. The diagnosis of HLH can be established in the presence of a molecular diagnosis consistent with HLH or the presence of five out of eight criteria: fever [greater than]38.5°C; splenomegaly; peripheral blood cytopenias; hypertriglyceridaemia; hypofibrinogenaemia; haemophagocytosis in bone marrow, spleen or liver; hyperferritinaemia ([greater than]500 ng/mL); and increased CD25/interleukin-2 receptor or reduced natural killer cell function.4The hallmark of diagnosis is observation of haemophagocytosis in the tissue. Pathophysiologically, viral infection of T cells leads to overproduction of cytokines such as tumour necrosis factor alpha and interferon gamma and can lead to uncontrolled histiocytic activity.
ISSN:1024-2708
2226-8707
DOI:10.12809/hkmj208815