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Introduction <p>HLH (hemophagocytic lymphohistiocytosis) syndrome is a life-threatening systemic hyperinflammatory syndrome that can occur in any age group. It typically develops in the setting of malignant or rheumatological diseases, or infections. Rarely, it can occur as a manifestation of underlying genetic inborn errors of immunity.</p> Case Presentation <p>We report a 20-year-old female, a confirmed case of dengue fever, who developed HLH syndrome. She presented with a 1-week history of fever. Four days into her admission, clinical deterioration was noted, accompanied by a rise in transaminases. At this juncture, a possible complication of hemophagocytic lymphohistiocytosis syndrome was suspected. This was confirmed by bone marrow examination. She was treated with steroids and eltrombopag. Though there was a rapid resolution of the inflammatory markers, it took a longer period for platelets to normalize.</p> Conclusion <p>This case highlights the timely diagnosis and treatment of a life-threatening complication in a common tropical infection. Eltrombopag, a thrombopoietin receptor agonist, could be considered as an add-on therapy in cases of persistent thrombocytopenia in a case of dengue-associated HLH syndrome.</p>

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HLH Syndrome in a Patient with Dengue Fever: A Case Report

  • 期刊论文

  • 发表日期：

    2025年10月8日

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  • Abraham M. Ittyachen,
  • Mintu John,
  • Eldhose Skariya,
  • Shilpa Paul,
  • Anju Sajeev,
  • Sandeep J. Alex,
  • Jasmine Jawahar,
  • Keerthi Maria Joshi,
  • Chithra Jayaprakash,
  • Binu Mary Bose,
  • Suneesh Soman Nair

摘要

Introduction

HLH (hemophagocytic lymphohistiocytosis) syndrome is a life-threatening systemic hyperinflammatory syndrome that can occur in any age group. It typically develops in the setting of malignant or rheumatological diseases, or infections. Rarely, it can occur as a manifestation of underlying genetic inborn errors of immunity.

Case Presentation

We report a 20-year-old female, a confirmed case of dengue fever, who developed HLH syndrome. She presented with a 1-week history of fever. Four days into her admission, clinical deterioration was noted, accompanied by a rise in transaminases. At this juncture, a possible complication of hemophagocytic lymphohistiocytosis syndrome was suspected. This was confirmed by bone marrow examination. She was treated with steroids and eltrombopag. Though there was a rapid resolution of the inflammatory markers, it took a longer period for platelets to normalize.

Conclusion

This case highlights the timely diagnosis and treatment of a life-threatening complication in a common tropical infection. Eltrombopag, a thrombopoietin receptor agonist, could be considered as an add-on therapy in cases of persistent thrombocytopenia in a case of dengue-associated HLH syndrome.