AUTHOR=De Smet Maarten A. J. , Bogaert Simon , Schauwvlieghe Alexander , Dendooven Amélie , Depuydt Pieter , Druwé Patrick 

TITLE=Case report: Hemorrhagic fever with renal syndrome presenting as hemophagocytic lymphohistiocytosis

JOURNAL=Frontiers in Medicine

VOLUME=9

YEAR=2022

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2022.1096900

DOI=10.3389/fmed.2022.1096900

ISSN=2296-858X

ABSTRACT=<p>Hemophagocytic lymphohistiocytosis may occur in patients with genetic predisposition and in sporadic cases due to malignancy or infection. We describe a 49-year old man with hemorrhagic fever, type 1 respiratory insufficiency and acute kidney injury. Diagnostic work up showed a hyperinflammatory syndrome, hypertriglyceridemia, hemophagocytosis, very high ferritin and significantly elevated sCD25. The findings were compatible with hemophagocytic lymphohistiocytosis based on the HLH-2004 criteria. Serological testing indentified <italic>Puumala virus</italic> as the causal pathogen. The patient was successfully treated with pulse corticosteroids, intravenous immunoglobins and supportive therapy.</p>