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. 2021 Aug 20:14:4687-4694.
doi: 10.2147/IJGM.S326270. eCollection 2021.

Clinical Characteristics of Adult Hemophagocytic Lymphohistiocytosis in the Emergency Department

Fang-Jie Zhang  1 , Guo-Qing Huang  1 , Jia Li  1 , Ji Xu  1 , Xiang-Min Li  1 , Ai-Min Wang  1
Affiliations

Clinical Characteristics of Adult Hemophagocytic Lymphohistiocytosis in the Emergency Department

Fang-Jie Zhang et al. Int J Gen Med. .

Abstract

Purpose: To determine the clinical manifestations and results of adult hemophagocytic lymphohistiocytosis (HLH) patients in our emergency department.

Methods: We retrospectively evaluated patients with HLH from 1 April 2018 to 31 December 2020. The clinical data of these patients (basic information, symptoms, vital signs, laboratory results, HLH diagnostic criteria, H Score, main treatments, outcomes) were collected.

Results: Thirty-three patients (23 males and 10 females; 40.55±18.78 years) with 34 clinical episodes (one male had two clinical episodes and died during the second episode) were enrolled. Twenty-five patients were placed in a "survivor" group, and nine patients were categorized into a "deceased" group. Fever, splenomegaly, hemoglobin <90 g/L and platelet count <100×109/L most commonly met the diagnostic standard for HLH. The H Score results in the survival group and deceased group was 212.4±37.18 and 252.1±40.95, respectively. Viral infection was the most common reason for HLH, followed by immune-system disease and cancer. Laboratory tests showed that deceased-group patients had multiple-organ dysfunction. Multivariate logistic regression showed that the lactate dehydrogenase (lactate dehydrogenase) level (P = 0.039; odds ratio, 0.999) was significantly related to death.

Conclusion: In the emergency department, HLH should be considered for critically ill patients with fever, splenomegaly, low hemoglobin and low platelet count. The H Score might be useful to diagnose HLH quickly. In our study, 26.47% of HLH patients died in the emergency department, and patients with a significantly increased lactate dehydrogenase level had a markedly increased risk of death.

Keywords: clinical characteristics; emergency department; hemophagocytic lymphohistiocytosis; lactate dehydrogenase; mortality.

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Conflict of interest statement

The authors declare that there are no conflicts of interest.

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