Cargando…
Tuberculosis-Associated Hemophagocytic Lymphohistiocytosis: A Review of Current Literature
Hemophagocytic lymphohistiocytosis (HLH) is a condition of immune dysregulation and hyperinflammation, leading to organ failure and death. Malignancy, autoimmune conditions, and infections, including Mycobacterium tuberculosis (TB), are all considered triggers of HLH. The aim of this study was to re...
Autores principales: | , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2023
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10455670/ https://www.ncbi.nlm.nih.gov/pubmed/37629407 http://dx.doi.org/10.3390/jcm12165366 |
_version_ | 1785096508883861504 |
---|---|
author | Fauchald, Trym Blomberg, Bjørn Reikvam, Håkon |
author_facet | Fauchald, Trym Blomberg, Bjørn Reikvam, Håkon |
author_sort | Fauchald, Trym |
collection | PubMed |
description | Hemophagocytic lymphohistiocytosis (HLH) is a condition of immune dysregulation and hyperinflammation, leading to organ failure and death. Malignancy, autoimmune conditions, and infections, including Mycobacterium tuberculosis (TB), are all considered triggers of HLH. The aim of this study was to review all reported cases of TB-associated HLH in English literature, and to summarize the epidemiology, diagnostics, treatment, and mortality in patients with concomitant HLH and TB. A systematic review of described cases with TB-associated HLH, via a structured literature search in the medical database PubMed, is presented. Additional articles were included through cross-referencing with existing review articles. Articles were reviewed based on a predetermined set of criteria. A total of 116 patients with TB-associated HLH were identified with a male:female ratio of about 3:2. The age at presentation ranged from 12 days to 83 years. Malignancy, autoimmunity, and renal failure were the most common comorbid conditions. Most patients received both tuberculostatic and specific immunomodulating treatment, which was associated with a 66% (48/73) survival rate compared to 56% (15/27) in those receiving only tuberculostatic treatment, and 0% (0/13) in those receiving only immunomodulating treatment. The survival rate was 55% overall. The overlapping presentation between disseminated TB and HLH poses challenging diagnostics and may delay diagnosis and treatment, leading to increased mortality. TB should be considered as a potential trigger of HLH; clinicians’ knowledge and awareness of this may result in the appropriate investigations needed to ensure diagnosis and proper treatment. |
format | Online Article Text |
id | pubmed-10455670 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-104556702023-08-26 Tuberculosis-Associated Hemophagocytic Lymphohistiocytosis: A Review of Current Literature Fauchald, Trym Blomberg, Bjørn Reikvam, Håkon J Clin Med Systematic Review Hemophagocytic lymphohistiocytosis (HLH) is a condition of immune dysregulation and hyperinflammation, leading to organ failure and death. Malignancy, autoimmune conditions, and infections, including Mycobacterium tuberculosis (TB), are all considered triggers of HLH. The aim of this study was to review all reported cases of TB-associated HLH in English literature, and to summarize the epidemiology, diagnostics, treatment, and mortality in patients with concomitant HLH and TB. A systematic review of described cases with TB-associated HLH, via a structured literature search in the medical database PubMed, is presented. Additional articles were included through cross-referencing with existing review articles. Articles were reviewed based on a predetermined set of criteria. A total of 116 patients with TB-associated HLH were identified with a male:female ratio of about 3:2. The age at presentation ranged from 12 days to 83 years. Malignancy, autoimmunity, and renal failure were the most common comorbid conditions. Most patients received both tuberculostatic and specific immunomodulating treatment, which was associated with a 66% (48/73) survival rate compared to 56% (15/27) in those receiving only tuberculostatic treatment, and 0% (0/13) in those receiving only immunomodulating treatment. The survival rate was 55% overall. The overlapping presentation between disseminated TB and HLH poses challenging diagnostics and may delay diagnosis and treatment, leading to increased mortality. TB should be considered as a potential trigger of HLH; clinicians’ knowledge and awareness of this may result in the appropriate investigations needed to ensure diagnosis and proper treatment. MDPI 2023-08-18 /pmc/articles/PMC10455670/ /pubmed/37629407 http://dx.doi.org/10.3390/jcm12165366 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Systematic Review Fauchald, Trym Blomberg, Bjørn Reikvam, Håkon Tuberculosis-Associated Hemophagocytic Lymphohistiocytosis: A Review of Current Literature |
title | Tuberculosis-Associated Hemophagocytic Lymphohistiocytosis: A Review of Current Literature |
title_full | Tuberculosis-Associated Hemophagocytic Lymphohistiocytosis: A Review of Current Literature |
title_fullStr | Tuberculosis-Associated Hemophagocytic Lymphohistiocytosis: A Review of Current Literature |
title_full_unstemmed | Tuberculosis-Associated Hemophagocytic Lymphohistiocytosis: A Review of Current Literature |
title_short | Tuberculosis-Associated Hemophagocytic Lymphohistiocytosis: A Review of Current Literature |
title_sort | tuberculosis-associated hemophagocytic lymphohistiocytosis: a review of current literature |
topic | Systematic Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10455670/ https://www.ncbi.nlm.nih.gov/pubmed/37629407 http://dx.doi.org/10.3390/jcm12165366 |
work_keys_str_mv | AT fauchaldtrym tuberculosisassociatedhemophagocyticlymphohistiocytosisareviewofcurrentliterature AT blombergbjørn tuberculosisassociatedhemophagocyticlymphohistiocytosisareviewofcurrentliterature AT reikvamhakon tuberculosisassociatedhemophagocyticlymphohistiocytosisareviewofcurrentliterature |