Hemophagocytic lymphohistiocytosis secondary to dengue in pediatric patient: case report
DOI:
https://doi.org/10.61708/q49sgq39Keywords:
Lymphohistiocytosis Hemophagocytic, dengue, paediatricsAbstract
Hemophagocytic lymphohistiocytosis (HLH) is a rare and potentially fatal condition characterized by exaggerated activation of the immune system. It can be seen in the context of several conditions such as infections, autoimmune diseases or cancer. Diagnosis requires the clinical context and compliance with the criteria proposed by the Histiocyte Society in 2004. Its management is based on the use of dexamethasone, cyclosporine A and etoposide. Here, we present the case of a 2-year-old male patient with persistent fever, signs of shock, and studies compatible with severe dengue who developed secondary HLH as a complication. The objective of this presentation is to describe a rare case in pediatrics, seeking to provide the reader with solid concepts about HLH, its management and complications.
Downloads
References
1. Raza M, Ali S. Hemophagocytic lymphohistiocytosis (HLH): a rare complication of dengue hemorrhagic fever. Cureus [Internet]. 2024 Oct 5 [cited 2025 Feb 2];16(10):e70895. Available from: http://www.ncbi.nlm.nih.gov/pubmed/39497882
2. See KC. Dengue-associated hemophagocytic lymphohistiocytosis: a narrative review of its identification and treatment. Pathog [Internet]. 2024 Apr 1 [cited 2025 Apr 6];13(4). Available from: https://pubmed.ncbi.nlm.nih.gov/38668287/ https://doi.org/10.3390/pathogens13040332 DOI: https://doi.org/10.3390/pathogens13040332
3. Chinnici A, Beneforti L, Pegoraro F, Trambusti I, Tondo A, Favre C, et al. Approaching hemophagocytic lymphohistiocytosis. Front Immunol. 2023;14:1234567. https://doi.org/10.3389/fimmu.2023.1210041 DOI: https://doi.org/10.3389/fimmu.2023.1210041
4. Chamba V, Borja A. Linfohistiocitosis hemofagocítica (HLH) en pediatría; nuevas opciones terapéuticas. Ecuador J Med. 2021;2(1):67. doi:10.46721/tejom-vol2issEsp-2022-56-67 https://doi.org/10.46721/tejom-vol2issEsp-2022-56-67 DOI: https://doi.org/10.46721/tejom-vol2issEsp-2022-56-67
5. Valero NJ, Polanco Peláez LG, Sacan Arriola MJ. Linfohistiocitosis hemofagocítica asociada al dengue grave. Enferm Invest. 2021;6(4):65-75. doi:10.31243/ei.uta.v6i4.1207.2021 https://doi.org/10.31243/ei.uta.v6i4.1207.2021 DOI: https://doi.org/10.31243/ei.uta.v6i4.1207.2021
6. Ramamoorthy L, Sivakumar N, Murugesan L, Kumar A. Hemophagocytic lymphohistiocytosis secondary to dengue fever in a pediatric patient: a case report. Cureus [Internet]. 2024 Apr 27 [cited 2025 Feb 2];16(4):e000000. Available from: https://pubmed.ncbi.nlm.nih.gov/38803771/
7. Papazachariou A, Ioannou P. Hemophagocytic lymphohistiocytosis triggered by herpes simplex virus 1 and 2: a narrative review. Hematol Rep [Internet]. 2024 Jul 26 [cited 2025 Feb 2];16(3):487-503. Available from: http://www.ncbi.nlm.nih.gov/pubmed/39189243 https://doi.org/10.3390/hematolrep16030047 DOI: https://doi.org/10.3390/hematolrep16030047
8. Sztajnbok F, Fonseca AR, Campos LR, Lino K, Rodrigues MCF, Silva RM, et al. Hemophagocytic lymphohistiocytosis and macrophage activation syndrome: two rare sides of the same devastating coin. Adv Rheumatol. 2024 Dec 1;64(1):123456. https://doi.org/10.1186/s42358-024-00370-2 DOI: https://doi.org/10.1186/s42358-024-00370-2
9. ahman HA, Aljabry AO. Paediatric haemophagocytic lymphohistiocytosis: clinical presentation and outcome of 20 patients at a single institution. Sudan J Paediatr [Internet]. 2023 [cited 2025 Feb 2];23(2):199-213. Available from: http://www.ncbi.nlm.nih.gov/pubmed/38380413 https://doi.org/10.24911/SJP.106-1659160002 DOI: https://doi.org/10.24911/SJP.106-1659160002
10. Ponnatt TS, Lilley CM, Mirza KM. Hemophagocytic lymphohistiocytosis. Arch Pathol Lab Med. 2022 Apr 1;146(4):507-19. https://doi.org/10.5858/arpa.2020-0802-RA DOI: https://doi.org/10.5858/arpa.2020-0802-RA
11. Canna SW, Marsh RA. Pediatric hemophagocytic lymphohistiocytosis [Internet]. 2020 [cited 2025 Feb 2]. Available from: http://ashpublications.org/blood/article-pdf/135/16/1332/1724141/bloodbld2019000936c.pdf https://doi.org/10.1182/blood.2019000936 DOI: https://doi.org/10.1182/blood.2019000936
12. Bhattacharya D, Angurana SK, Nallasamy K, Iyer R, Jayashree M. Severe dengue and associated hemophagocytic lymphohistiocytosis in PICU. Indian J Pediatr. 2019;86(12):1094-8. doi:10.1007/s12098-019-03040-0 https://doi.org/10.1007/s12098-019-03040-0 DOI: https://doi.org/10.1007/s12098-019-03040-0
13. La Rosée P, Horne AC, Hines M, Greenwood TVB, Machowicz R, Berliner N, et al. Recommendations for the management of hemophagocytic lymphohistiocytosis in adults. Blood [Internet]. 2019 Jun 6 [cited 2025 Feb 2];133(23):2465-77. Available from: https://pubmed.ncbi.nlm.nih.gov/30992265/ https://doi.org/10.1182/blood.2018894618 DOI: https://doi.org/10.1182/blood.2018894618
14. Wan Fariza Wan Jamaludin, Petrick Periyasamy, Wan Rahiza Wan Mat, S. Fadilah Abdul Wahid, Dengue infection associated hemophagocytic syndrome: Therapeutic interventions and outcome, Journal of Clinical Virology, Volume 69, 2015, Pages 91-95, ISSN 1386-6532, https://doi.org/10.1016/j.jcv.2015.06.004 DOI: https://doi.org/10.1016/j.jcv.2015.06.004
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Copyright: © Los autores. Publicado por Gaceta Médica JBG.
This work is licensed under a Creative Commons Attribution 4.0 International License.
