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REVIEW  INFECTIOUS DISEASES AND CHEMOTHERAPY CONSEQUENCES: AN INVESTIGATION TO IMPROVE THE QUALITY OF LIFE IN PATIENTS 

Gazzetta Medica Italiana Archivio per le Scienze Mediche 2018 October;177(10):556-70

DOI: 10.23736/S0393-3660.18.03814-7

Copyright © 2018 EDIZIONI MINERVA MEDICA

language: English

Secondary hemophagocytic lymphohistiocytosis in vector borne diseases: a systematic review

Chiara IARIA 1 , Claudia COLOMBA 2, Valentina CAPUTO 3, Teresa REA 4, Nicola SERRA 4, Davide MILILLI 2, Annamaria DE LUCA 2, Benedetta ROMANIN 2, Francesco SCARLATA 2

1 Unit of Infectious Diseases, Civico - Di Cristina - Benfratelli Hospitals, Palermo, Italy; 2 G. D’Alessandro Department of Health Promotion Sciences and Mother and Child Care, University of Palermo, Palermo, Italy; 3 Department of Internal and Specialist Medicine (Di.Bi.Mi.S), Paolo Giaccone Polyclinic, University of Palermo, Palermo, Italy; 4 School of Medicine and Surgery, Federico II University, Naples, Italy


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INTRODUCTION: Hemophagocytic lymphohistiocytosis (HLH), is a potentially fatal hyperinflammatory syndrome characterized by fever, hepatosplenomegaly, and cytopenia. HLH can be either primary, with a genetic etiology, or secondary, associated with malignancies, autoimmune diseases, or infections.
EVIDENCE ACQUISITION: Purpose of the study is to focus on secondary HLH complicating vector borne diseases. PubMed search of human cases of HLH occurring during zoonotic diseases was performed combining the terms (“haemophagocytic” OR “haemophagocytosis” OR “hemophagocytosis” OR “hemophagocytic” OR “erythrophagocytosis” OR “macrophage activation syndrome”) with each one of the etiological agents of arthropod-borne diseases. The PubMed search identified 313 papers. Duplicate publications or papers not reporting clinical cases were excluded.
EVIDENCE SYNTHESIS: After a scrupulous analysis, 233 papers were further evaluated. Among bacterial diseases, most papers reported cases occurring during rickettsial diseases and Q fever. Regarding viral diseases, most of the cases were reported in patients with dengue. Among the protozoan diseases, most of the cases were reported in patients with visceral leishmaniasis and malaria.
CONCLUSIONS: HLH may be triggered by vector-borne diseases. Secondary HLH can delay the correct diagnosis of these diseases and can contribute to an adverse outcome.


KEY WORDS: Hemophagocytic lymphohistiocytosis - Zoonoses - Macrophage activation - Q fever

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