Haemophagocytic lymphohistiocytosis in adult critical care.
J Intensive Care Soc
; 21(3): 256-268, 2020 Aug.
Article
em En
| MEDLINE
| ID: mdl-32782466
ABSTRACT
Haemophagocytic lymphohistiocytosis (HLH) is a syndrome of severe immune dysregulation, characterised by extreme inflammation, fever, cytopaenias and organ dysfunction. HLH can be triggered by conditions such as infection, autoimmune disease and malignancy, among others. Both a familial and a secondary form have been described, the latter being increasingly recognised in adult patients with critical illness. HLH is difficult to diagnose, often under-recognised and carries a high mortality. Patients can present in a very similar fashion to sepsis and the two syndromes can co-exist and overlap, yet HLH requires specific immunosuppressive therapy. HLH should be actively excluded in patients with presumed sepsis who either lack a clear focus of infection or who are not responding to energetic infection management. Elevated serum ferritin is a key biomarker that may indicate the need for further investigations for HLH and can guide treatment. Early diagnosis and a multidisciplinary approach to HLH management may save lives.
Texto completo:
1
Bases de dados:
MEDLINE
Tipo de estudo:
Screening_studies
Idioma:
En
Revista:
J Intensive Care Soc
Ano de publicação:
2020
Tipo de documento:
Article
País de afiliação:
Reino Unido