Clinical and laboratory characteristics of secondary hemophagocytic syndrome caused by different etiologies
10.3760/cma.j.issn.1671-0282.2024.07.019
- VernacularTitle:不同病因继发噬血细胞综合征的临床及实验室特征分析
- Author:
Yuanyuan PEI
1
;
Ranran YAO
;
Lingjie CAO
;
Fengtao YANG
;
Renge LIANG
;
Wenfeng HUANG
;
Jihong ZHU
Author Information
1. 北京大学人民医院急诊科，北京 100044
- Keywords:
Secondary hemophagocytic syndrome;
macrophage activation syndrome;
Etiological distribution;
Infection
- From:
Chinese Journal of Emergency Medicine
2024;33(7):999-1005
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To classify the etiology of secondary hemophagocytic syndrome (sHLH) and explore its clinical, laboratory and therapeutic characteristics in order to deepen the understanding of the disease.Method:A retrospective observational study was conducted on sHLH patients who were treated at Peking University People's Hospital from January 2016 to December 2021. Patients under the age of 18 and those with missing clinical data were excluded. The distribution of departments visited and etiologies of sHLH were analyzed. Baseline data, clinical characteristics, complications, laboratory data, treatment, and in-hospital outcomes of sHLH were collected. The sHLH patients were then divided into 3 groups including malignancy group, macrophage activation syndrome (MAS) group and other etiologies (mainly infection) group. Intergroup comparisons were performed using chi-square tests, analysis of variance, Mann-Whitney tests, and other statistical methods.Results:A total 169 patients were enrolled, among these patients, 27.8% were malignancy-related HLH, 47.9% were MAS, and 24.3% were other etiologies related HLH. Statistical analysis revealed that the clinical characteristics of other etiological group was highly consistent with the malignancy group, including more and severer peripheral blood cell reduction, higher sCD25 levels, more Epstein-Barr virus infection, and the prognosis was similar, both were with more than 50% in-hospital mortality. And the incidence of hemophagocytosis was highest in other etiological groups (65.9%). In contrast, MAS group was with an obviously lower mortality of 17.3% ( P<0.05). Meanwhile, treatments including methylprednisolone pulse, cyclosporine A and interleukin-2 were used frequently in MAS group. Conclusion:Malignancy related HLH and other etiologies related HLH exhibit more similar clinical characteristics and prognosis, while the MAS group, has a milder overall condition and better prognosis.
