Universität zu Köln

Eichenauer, D. A., Lachmann, G. and La Rosee, P. (2021). Hemophagocytic lymphohistiocytosis in critically ill patients. Med. Klin.-Intensivmed Notfallmed., 116 (2). S. 129 - 135. HEIDELBERG: SPRINGER HEIDELBERG. ISSN 2193-6226

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Abstract

Hemophagocytic lymphohistiocytosis (HLH) is a hyperinflammation syndrome. In adults, secondary HLH is mostly observed. HLH is often triggered by infections, malignancies or autoimmune disorders. However, HLH cases in association with immunotherapies have been described recently. HLH in critically ill patients is often difficult to differentiate from sepsis. Both conditions can also be present at the same time. Early diagnosis and timely initiation of an adequate immunosuppressive therapy are essential for the further course and the prognosis of HLH. Therefore, HLH should represent a differential diagnosis in critically ill patients with persistent fever and additional symptoms (e.g. enlarged spleen, neurologic symptoms) or laboratory parameters (e.g. hyperferritinemia, cytopenia, increased transaminases) compatible with HLH. The diagnosis of HLH is made using the HLH-2004 criteria. The probability of the presence of HLH can be calculated using the HScore. High-dose corticosteroids represent the cornerstone of HLH treatment. Etoposide, immunoglobulins, anakinra or other drugs are added depending on the trigger. The course of HLH is influenced by the time of treatment initiation, the underlying trigger and the response to treatment. Generally, the prognosis of critically ill HLH patients is poor.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Eichenauer, D. A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Lachmann, G. UNSPECIFIED UNSPECIFIED UNSPECIFIED La Rosee, P. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-582905
DOI:	10.1007/s00063-021-00781-9
Journal or Publication Title:	Med. Klin.-Intensivmed Notfallmed.
Volume:	116
Number:	2
Page Range:	S. 129 - 135
Date:	2021
Publisher:	SPRINGER HEIDELBERG
Place of Publication:	HEIDELBERG
ISSN:	2193-6226
Language:	German
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language Medicine, General & Internal Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/58290