Successful rescue of acute liver failure and hemophagocytic lymphohistiocytosis following varicella infection: A case report and review of literature

Figure 3 Inferred links between varicella infection, acute liver failure and hemophagocytic lymphohistiocytosis. In the present case, varicella-zoster virus (VZV) was identified as a causative agent for acute liver failure (ALF). Meanwhile, hemophagocytic lymphohistiocytosis (HLH) triggered by VZV infection may, in turn, have contributed to the progression of ALF. Accumulating evidence pointed towards a similar immune dysregulation pattern in ALF and HLH. It may be inferred that at least a subset of ALF cases may manifest with the HLH spectrum in a shared pathophysiology predominantly affecting the liver. VZV: Varicella-zoster virus; HLH: Hemophagocytic lymphohistiocytosis; ALF: Acute liver failure