Published online Aug 6, 2021. doi: 10.12998/wjcc.v9.i22.6403
Peer-review started: January 24, 2021
First decision: March 8, 2021
Revised: March 12, 2021
Accepted: May 8, 2021
Article in press: May 8, 2021
Published online: August 6, 2021
Processing time: 184 Days and 12 Hours
Malaria-associated secondary hemophagocytic lymphohistiocytosis (HLH) is rare. Moreover, the literature on malaria-associated HLH is sparse, and there are no similar cases reported in China.
We report the case of a 29-year-old woman with unexplained intermittent fever who was admitted to our hospital due to an unclear diagnosis. The patient concealed her history of travel to Nigeria before onset. We made a diagnosis of malaria-associated secondary HLH. The treatment strategy for this patient included treatment of the inciting factor (artemether for 9 d followed by artemisinin for 5 d), the use of immunosuppressants (steroids, intravenous immunoglobulin) and supportive care. The patient was discharged in normal physical condition after 25 d of intensive care. No relapses were documented on follow-up at six months and 1 year.
Early diagnosis of the primary disease along with timely intervention and a multidisciplinary approach can help patients achieve a satisfactory outcome.
Core Tip: We found an unexpected association between malaria and hemophagocytic lymphohistiocytosis (HLH) in this case. Literature on malaria-associated HLH is sparse. There are no similar cases reported in China. In this case, we made the diagnosis based on HLH-2004 criteria and adopted new biomarkers to make the diagnosis of HLH. Through multidisciplinary treatment, the patient was discharged in normal physical condition. This case highlights the importance of early diagnosis and timely therapy of the primary disease to secondary HLH.