Wang DD, Wu S, Kong BB, Song LL. Hemophagocytic lymphohistiocytosis with jaundice as first manifestation: A case report. World J Clin Cases 2023; 11(34): 8212-8218 [PMID: 38130789 DOI: 10.12998/wjcc.v11.i34.8212]
Corresponding Author of This Article
Lin-Lin Song, PhD, Chief Physician, Doctor, Department of Emergency Medicine, Beijing Tsinghua Changgung Hospital, Medical Center, Tsinghua University, No. 168 Litang Road, Changping District, Beijing 102218, China. slla01139@btch.edu.cn
Research Domain of This Article
Hematology
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. Dec 6, 2023; 11(34): 8212-8218 Published online Dec 6, 2023. doi: 10.12998/wjcc.v11.i34.8212
Hemophagocytic lymphohistiocytosis with jaundice as first manifestation: A case report
Dan-Dan Wang, Sheng Wu, Bing-Bing Kong, Lin-Lin Song
Dan-Dan Wang, Sheng Wu, Bing-Bing Kong, Lin-Lin Song, Department of Emergency Medicine, Beijing Tsinghua Changgung Hospital, Medical Center, Tsinghua University, Beijing 102218, China
Author contributions: Wu S and Kong BB Participated in the treatment process and tried hard to save this patient; Wang DD wrote the manuscript; Wu S and Song LL revised this manuscript; all authors have read and approved the final manuscript.
Informed consent statement: Informed written consent was obtained from the patient for the publication of this case report and any accompanying images.
Conflict-of-interest statement: The authors declare that there is no conflict of interest to disclose.
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: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Lin-Lin Song, PhD, Chief Physician, Doctor, Department of Emergency Medicine, Beijing Tsinghua Changgung Hospital, Medical Center, Tsinghua University, No. 168 Litang Road, Changping District, Beijing 102218, China. slla01139@btch.edu.cn
Received: October 3, 2023 Peer-review started: October 3, 2023 First decision: November 1, 2023 Revised: November 11, 2023 Accepted: November 27, 2023 Article in press: November 27, 2023 Published online: December 6, 2023
Core Tip
Core Tip: We report the case of a 71-year-old female patient who presented with jaundice. Obstructive jaundice with choledocholithiasis and gallstones was suggested. Then, we found splenomegaly, cytopenia, hypertriglyceridemia, hypofibrinogenemia, and elevated ferritin. Bone marrow biopsy revealed hemophagocytosis. Later, cardiac arrest occurred when she returned after the surgery. We considered that hemophagocytic lymphohistiocytosis (HLH) was triggered by septic shock. The patient’s condition deteriorated rapidly, with multiple organ dysfunction. Corticosteroid therapy and symptomatic treatment failed to save her life. Jaundice rarely presents as the first symptom in HLH patients. Elevated direct bilirubin was associated with prognosis. Clinicians should try to reduce missed diagnoses and misdiagnoses.
