| Journal of Medical Cases, ISSN 1923-4155 print, 1923-4163 online, Open Access |
| Article copyright, the authors; Journal compilation copyright, J Med Cases and Elmer Press Inc |
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Case Report
Volume 000, Number 000, February 2025, pages 000-000
Hemophagocytic Lymphohistiocytosis After Treatment With Checkpoint Inhibitor Therapy
Table
| The diagnosis of HLH can be established if criterion 1 or 2 is fulfilled. HLH: hemophagocytic lymphohistiocytosis; NK: natural killer; sCD25: soluble CD25; IL-2: interleukin-2. |
| Criterion 1. A molecular diagnosis consistent with HLH |
| Criterion 2. Diagnostic criteria for HLH fulfilled (five of the eight criteria below) |
| 1) Fever |
| 2) Splenomegaly |
| 3) Cytopenias (affecting ≥ 2 of 3 lineages in peripheral blood) |
| 4) Hemoglobin < 90 g/L (hemoglobin < 100 g/L in infants < 4 weeks) |
| 5) Platelets < 100 × 109/L |
| 6) Neutrophils < 1.0 × 109/L |
| 7) Hypertriglyceridemia and/or hypofibrinogenemia |
| 8) Fasting triglycerides > 3.0 mmol/L (i.e., > 265 mg/dL) |
| 9) Fibrinogen ≤ 1.5 g/L |
| 10) Hemophagocytosis in the bone marrow, spleen or lymph node |
| 11) No evidence of malignancy |
| 12) Low or no NK cell activity (according to local laboratory reference) |
| 13) Ferritin ≥ 500 µg/L |
| 14) sCD25 (i.e., soluble IL-2 receptor) ≥ 2,400 U/mL |