Zhou X, Duan ML. Malaria-associated secondary hemophagocytic lymphohistiocytosis: A case report. World J Clin Cases 2021; 9(22): 6403-6409 [PMID: 34435005 DOI: 10.12998/wjcc.v9.i22.6403]
Corresponding Author of This Article
Mei-Li Duan, MD, PhD, Chief Doctor, Professor, Department of Critical Care Medicine, Beijing Friendship Hospital, Capital Medical University, No. 95 Yong'an Road, Xicheng District, Beijing 100054, China. dmeili@ccmu.edu.cn
Research Domain of This Article
Critical Care Medicine
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Aug 6, 2021; 9(22): 6403-6409 Published online Aug 6, 2021. doi: 10.12998/wjcc.v9.i22.6403
Malaria-associated secondary hemophagocytic lymphohistiocytosis: A case report
Xiao Zhou, Mei-Li Duan
Xiao Zhou, Mei-Li Duan, Department of Critical Care Medicine, Beijing Friendship Hospital, Capital Medical University, Beijing 100054, China
Author contributions: Duan ML developed the treatment strategies for the patient; Zhou X administered the treatments and read the literature; Zhou X was a major contributor in writing the manuscript; all authors issued final approval for the version to be submitted.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Mei-Li Duan, MD, PhD, Chief Doctor, Professor, Department of Critical Care Medicine, Beijing Friendship Hospital, Capital Medical University, No. 95 Yong'an Road, Xicheng District, Beijing 100054, China. dmeili@ccmu.edu.cn
Received: January 24, 2021 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
Abstract
BACKGROUND
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.
CASE SUMMARY
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.
CONCLUSION
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.
