Clinical analysis of 25 cases of hemophagocytic syndrome with multiple organ failure

Abstract

Objective To analyze and summarize the clinical characteristics of hemophagocytic syndrome featured by fever and multiple organ failure and improve the ability of early diagnosis and treatment. Methods A retrospective analysis of the clinical data of 25 patients with hemophagocytic syndrome featured by fever and multiple organ failure in MICU from May 2014 to December 2017 was performed. Results Of 25 patients, 16 cases were male, and 9 were female. The average age was (38.32±15.80) years old. All patients were diagnosed by HLH-2004 standards, including 6 cases of lymphoma, 3 cases of EB virus infection, 3 cases of systemic lupus erythematosus (SLE), 2 cases of leukemia, 1 case of cytomegalovirus infection, 2 cases of fungal infection, 1 case of adenovirus infection, 1 case of cadmium poisoning, and 6 cases with unknown causes. Blood system, digestive system and circulatory system involvement were found in 25 cases (100%), respiratory infection in 20 cases (80%), kidney involvement in 13 cases (52%), central nervous system involvement in 12 cases (48%) and increased lactic acid level in 21 cases (84%). 16 patients died of multiple organ failure, and the mortality was 64%. Conclusion Hemophagocytic syndrome should be highly suspected if patients have fever longer than three weeks with multiple organ damage, especially with liver failure. These patients need early diagnosis and treatment for better prognosis. With multiple organ failure the prognosis is fairly poor. Key words: Hemophagocytic syndrome; Multiple organ failure; Fever