Risk Factors of Hemophagocytic Lymphohistiocytosis in Adults with Fever of Unknown Origin: A Retrospective Study

Fangbing Tian,1 Nana Xie,1 Wenjin Sun,2 Wencong Zhang,1 Wenyuan Zhang,1 Jia Chen,1 Qiurong Ruan,3,* Jianxin Song1,* 1Department of Infectious Diseases, Tongji Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic of Chi...

Full description

Saved in:
Bibliographic Details
Main Authors: Tian F, Xie N, Sun W, Zhang W, Chen J, Ruan Q, Song J
Format: Article
Language:English
Published: Dove Medical Press 2025-01-01
Series:International Journal of General Medicine
Subjects:
Online Access:https://www.dovepress.com/risk-factors-of-hemophagocytic-lymphohistiocytosis-in-adults-with-feve-peer-reviewed-fulltext-article-IJGM
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1832592043048697856
author Tian F
Xie N
Sun W
Zhang W
Zhang W
Chen J
Ruan Q
Song J
author_facet Tian F
Xie N
Sun W
Zhang W
Zhang W
Chen J
Ruan Q
Song J
author_sort Tian F
collection DOAJ
description Fangbing Tian,1 Nana Xie,1 Wenjin Sun,2 Wencong Zhang,1 Wenyuan Zhang,1 Jia Chen,1 Qiurong Ruan,3,* Jianxin Song1,* 1Department of Infectious Diseases, Tongji Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China; 2Department of Infectious Diseases, Ezhou Central Hospital, Ezhou, People’s Republic of China; 3Institute of Pathology, Tongji Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China*These authors contributed equally to this workCorrespondence: Jianxin Song, Department of Infectious Diseases, Tongji Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China, Email songsingsjx@sina.com Qiurong Ruan, Institute of Pathology, Tongji Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China, Email ruanqiurong@sina.comPurpose: Hemophagocytic lymphohistiocytosis (HLH) is a critical syndrome with a high mortality rate. In clinical practice, some patients with fever of unknown origin (FUO) can develop HLH, further complicating the diagnosis and treatment. However, studies on HLH in adults with FUO are limited. This study aimed to investigate the clinical characteristics of adult patients with FUO to facilitate the early identification of those at high risk of developing HLH.Patients and Methods: We collected data from hospitalized patients with FUO between January 2014 and December 2020. Risk factors for HLH in adults with FUO were analyzed using univariate and multivariate analysis.Results: A total of 988 patients with FUO were included in the study. The incidence of HLH in adults with FUO was 6.4%, with hematological tumors being the primary cause. Multivariate analysis indicated that skin rash and elevated alanine aminotransferase, total bilirubin, triglycerides, lactate dehydrogenase, and ferritin levels were independent risk factors for HLH in adults with FUO.Conclusion: This study revealed the incidence rate, etiology distribution, and risk factors for HLH in adults with FUO. Comprehensive assessment of clinical and laboratory data at admission can assist in the early identification of FUO patients at risk for HLH.Keywords: Hemophagocytic lymphohistiocytosis, fever of unknown origin, etiology distribution, risk factors
format Article
id doaj-art-00415cc6e7a3420196673a6a440a80fa
institution Kabale University
issn 1178-7074
language English
publishDate 2025-01-01
publisher Dove Medical Press
record_format Article
series International Journal of General Medicine
spelling doaj-art-00415cc6e7a3420196673a6a440a80fa2025-01-21T16:58:06ZengDove Medical PressInternational Journal of General Medicine1178-70742025-01-01Volume 1832133099465Risk Factors of Hemophagocytic Lymphohistiocytosis in Adults with Fever of Unknown Origin: A Retrospective StudyTian FXie NSun WZhang WZhang WChen JRuan QSong JFangbing Tian,1 Nana Xie,1 Wenjin Sun,2 Wencong Zhang,1 Wenyuan Zhang,1 Jia Chen,1 Qiurong Ruan,3,* Jianxin Song1,* 1Department of Infectious Diseases, Tongji Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China; 2Department of Infectious Diseases, Ezhou Central Hospital, Ezhou, People’s Republic of China; 3Institute of Pathology, Tongji Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China*These authors contributed equally to this workCorrespondence: Jianxin Song, Department of Infectious Diseases, Tongji Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China, Email songsingsjx@sina.com Qiurong Ruan, Institute of Pathology, Tongji Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China, Email ruanqiurong@sina.comPurpose: Hemophagocytic lymphohistiocytosis (HLH) is a critical syndrome with a high mortality rate. In clinical practice, some patients with fever of unknown origin (FUO) can develop HLH, further complicating the diagnosis and treatment. However, studies on HLH in adults with FUO are limited. This study aimed to investigate the clinical characteristics of adult patients with FUO to facilitate the early identification of those at high risk of developing HLH.Patients and Methods: We collected data from hospitalized patients with FUO between January 2014 and December 2020. Risk factors for HLH in adults with FUO were analyzed using univariate and multivariate analysis.Results: A total of 988 patients with FUO were included in the study. The incidence of HLH in adults with FUO was 6.4%, with hematological tumors being the primary cause. Multivariate analysis indicated that skin rash and elevated alanine aminotransferase, total bilirubin, triglycerides, lactate dehydrogenase, and ferritin levels were independent risk factors for HLH in adults with FUO.Conclusion: This study revealed the incidence rate, etiology distribution, and risk factors for HLH in adults with FUO. Comprehensive assessment of clinical and laboratory data at admission can assist in the early identification of FUO patients at risk for HLH.Keywords: Hemophagocytic lymphohistiocytosis, fever of unknown origin, etiology distribution, risk factorshttps://www.dovepress.com/risk-factors-of-hemophagocytic-lymphohistiocytosis-in-adults-with-feve-peer-reviewed-fulltext-article-IJGMhemophagocytic lymphohistiocytosisfever of unknown originetiology distributionrisk factors
spellingShingle Tian F
Xie N
Sun W
Zhang W
Zhang W
Chen J
Ruan Q
Song J
Risk Factors of Hemophagocytic Lymphohistiocytosis in Adults with Fever of Unknown Origin: A Retrospective Study
International Journal of General Medicine
hemophagocytic lymphohistiocytosis
fever of unknown origin
etiology distribution
risk factors
title Risk Factors of Hemophagocytic Lymphohistiocytosis in Adults with Fever of Unknown Origin: A Retrospective Study
title_full Risk Factors of Hemophagocytic Lymphohistiocytosis in Adults with Fever of Unknown Origin: A Retrospective Study
title_fullStr Risk Factors of Hemophagocytic Lymphohistiocytosis in Adults with Fever of Unknown Origin: A Retrospective Study
title_full_unstemmed Risk Factors of Hemophagocytic Lymphohistiocytosis in Adults with Fever of Unknown Origin: A Retrospective Study
title_short Risk Factors of Hemophagocytic Lymphohistiocytosis in Adults with Fever of Unknown Origin: A Retrospective Study
title_sort risk factors of hemophagocytic lymphohistiocytosis in adults with fever of unknown origin a retrospective study
topic hemophagocytic lymphohistiocytosis
fever of unknown origin
etiology distribution
risk factors
url https://www.dovepress.com/risk-factors-of-hemophagocytic-lymphohistiocytosis-in-adults-with-feve-peer-reviewed-fulltext-article-IJGM
work_keys_str_mv AT tianf riskfactorsofhemophagocyticlymphohistiocytosisinadultswithfeverofunknownoriginaretrospectivestudy
AT xien riskfactorsofhemophagocyticlymphohistiocytosisinadultswithfeverofunknownoriginaretrospectivestudy
AT sunw riskfactorsofhemophagocyticlymphohistiocytosisinadultswithfeverofunknownoriginaretrospectivestudy
AT zhangw riskfactorsofhemophagocyticlymphohistiocytosisinadultswithfeverofunknownoriginaretrospectivestudy
AT zhangw riskfactorsofhemophagocyticlymphohistiocytosisinadultswithfeverofunknownoriginaretrospectivestudy
AT chenj riskfactorsofhemophagocyticlymphohistiocytosisinadultswithfeverofunknownoriginaretrospectivestudy
AT ruanq riskfactorsofhemophagocyticlymphohistiocytosisinadultswithfeverofunknownoriginaretrospectivestudy
AT songj riskfactorsofhemophagocyticlymphohistiocytosisinadultswithfeverofunknownoriginaretrospectivestudy