- A retrospective analysis of etiology and outcomes of hemophagocytic lymphohistiocytosis in children and adults
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Abraham Kwak, Nani Jung, Ye Jee Shim, Heung Sik Kim, Hyun Ji Lim, Jae Min Lee, Mi Hwa Heo, Young Rok Do
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Yeungnam Univ J Med. 2021;38(3):208-218. Published online November 27, 2020
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DOI: https://doi.org/10.12701/yujm.2020.00591
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- Background
Hemophagocytic lymphohistiocytosis (HLH) is a rare but severe, life-threatening inflammatory condition if untreated. We aimed to investigate the etiologies, outcomes, and risk factors for death in children and adults with HLH.
Methods The medical records of patients who met the HLH criteria of two regional university hospitals in Korea between January 2001 and December 2019 were retrospectively investigated.
Results Sixty patients with HLH (35 children and 25 adults) were included. The median age at diagnosis was 7.0 years (range, 0.1–83 years), and the median follow-up duration was 8.5 months (range, 0–204 months). Four patients had primary HLH, 48 patients had secondary HLH (20 infection-associated, 18 neoplasm-associated, and 10 autoimmune-associated HLH), and eight patients had HLH of unknown cause. Infection was the most common cause in children (14/35, 40.0%), whereas neoplasia was the most common cause in adults (13/25, 52.0%). Twenty-eight patients were treated with HLH-2004/94 immunochemotherapy. The 5-year overall survival (OS) rate for all HLH patients was 59.9%. The 5-year OS rates for patients with primary, infection-associated, neoplasm-associated, autoimmune-associated, and unknown cause HLH were 25.0%, 85.0%, 26.7%, 87.5%, and 62.5%, respectively. Using multivariate analysis, neoplasm-induced HLH (p=0.001) and a platelet count <50×109/L (p=0.008) were identified as independent risk factors for poor prognosis in patients with HLH.
Conclusion Infection was the most common cause of HLH in children, while it was neoplasia in adults. The 5-year OS rate for all HLH patients was 59.9%. HLH caused by an underlying neoplasm or a low platelet count at the time of diagnosis were risk factors for poor prognosis.
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Citations
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- Prevalence and mortality of haemophagocytic lymphohistiocytosis in dengue fever: a systematic review and meta-analysis
Leong Tung Ong, Roovam Balasubramaniam Transactions of The Royal Society of Tropical Medicine and Hygiene.2024;[Epub] CrossRef - Predicting relapsed/refractory disease in childhood hemophagocytic lymphohistiocytosis based on clinical features at diagnosis: A 13-year single-institute retrospective study in Thailand
Pattranan Kusontammarat, Chane Choed-Amphai, Lalita Sathitsamitphong, Watchareewan Sontichai, Rungrote Natesirinilkul, Pimlak Charoenkwan Annals of Hematology.2024;[Epub] CrossRef - Autoimmune encephalitis followed by hemophagocytic lymph histiocytosis: a case report
Li Huang, Jie Tan, Peihao Lin, Zixuan Chen, Qihua Huang, Haiyan Yao, Lihong Jiang, Baoyi Long, Youming Long Frontiers in Immunology.2024;[Epub] CrossRef - Hemophagocytic Lymphohistiocytosis Triggered by Herpes Simplex Virus 1 and 2: A Narrative Review
Andria Papazachariou, Petros Ioannou Hematology Reports.2024; 16(3): 487. CrossRef - Spontaneous Resolution of Hemophagocytic Lymphohistiocytosis in a Child Infected with Epstein–Barr Virus
Rita Alfattal, Hussain Sadeq, Abdullah Ali Journal of Applied Hematology.2023; 14(1): 57. CrossRef - Pediatric inborn errors of immunity causing hemophagocytic lymphohistiocytosis: Case report and review of the literature
María Soledad Caldirola, Andrea Gómez Raccio, Daniela Di Giovanni, María Isabel Gaillard, María Victoria Preciado Journal of Leukocyte Biology.2022; 112(4): 607. CrossRef - Secondary Hemophagocytic Lymphohistiocytosis and Autoimmune Cytopenias: Case Description and Review of the Literature
Bruno Fattizzo, Marta Ferraresi, Juri Giannotta, Wilma Barcellini Journal of Clinical Medicine.2021; 10(4): 870. CrossRef - HLH-Like Syndrome and Rhabdomyolysis in an Adolescent Patient
Lauren T. Maloney, Bronwyn Baz, Dia Hazra Pediatrics.2021;[Epub] CrossRef
- Sciatic nerve neurolymphomatosis as the initial presentation of primary diffuse large B-cell lymphoma: a rare cause of leg weakness
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Kyoung Tae Kim, Se Il Kim, Young Rok Do, Hye Ra Jung, Jang Hyuk Cho
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Yeungnam Univ J Med. 2021;38(3):258-263. Published online April 15, 2021
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DOI: https://doi.org/10.12701/yujm.2021.00983
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6,061
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- Neurolymphomatosis (NL) is defined as the involvement of the peripheral nervous system in lymphocytic invasion. It is a very rare form of lymphoma that may occur as an initial presentation or recurrence. It affects various peripheral nervous structures and can therefore mimic disc-related nerve root pathology or compressive mononeuropathy. NL often occurs in malignant B-cell non-Hodgkin lymphomas. Notwithstanding its aggressiveness or intractability, NL should be discriminated from other neurologic complications of lymphoma. Herein, we present a case of primary NL as the initial presentation of diffuse large B-cell lymphoma (DLBCL) of the sciatic nerve. The patient presented with weakness and pain in his left leg but had no obvious lesion explaining the neurologic deficit on initial lumbosacral and knee magnetic resonance imaging (MRI). NL of the left sciatic nerve at the greater sciatic foramen was diagnosed based on subsequent hip MRI, electrodiagnostic test, positron emission tomography/computed tomography, and nerve biopsy findings. Leg weakness slightly improved after chemotherapy and radiotherapy. We report a case wherein NL, a rare cause of leg weakness, manifested as the initial presentation of primary DLBCL involving the sciatic nerve at the greater sciatic foramen.
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Citations
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- Primary peripheral nerve lymphoma: a case report and literature review
Di Wu, Hui Liu, Lingyu Hao, Xu Han, Sihan Wang, Yijia Xiang, Shizhu Yu, Yi Wang Neurological Sciences.2024; 45(4): 1447. CrossRef - A case report of surgical management of a solitary Non-Hodgkin's Lymphoma (NHL) arising from the proximal sciatic nerve
Sivakumaran Gobinath, Ganeshamoorthy Sritharan, Subramaniam Bakeerathan, Paramanathan Shathana, Umesh Jayarajah International Journal of Surgery Case Reports.2023; 111: 108817. CrossRef
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