Clinical analysis of secondary hemophagocytic syndrome in children in Gansu province

TL;DR

This study examines the causes, symptoms, and outcomes of secondary hemophagocytic syndrome in children in Gansu Province, China.

Contribution

The study identifies leishmania and EB virus as common causes of HLH in the region and highlights better prognosis for leishmania-related cases.

Findings

Leishmania and EB virus infections are the most common causes of HLH in Gansu Province.

Children with leishmania-related HLH had a 100% cure rate compared to 26.67% for EB virus-related cases.

Laboratory markers like ALT, PCT, and D-dimer levels varied significantly between infection groups.

Abstract

This study aims to explore and analyze the various causes, clinical features, and prognostic differences of secondary hemophagocytic syndrome (SHS) in children in Gansu Province, China.

This study used a retrospective analysis method, selected 43 children with HLH who were treated in the PICU at the First Hospital of Lanzhou University from January 2019 to January 2025. Based on their primary diseases, the subjects were categorized into groups for VL, EB virus infection, and other infections. The clinical manifestations, laboratory results and clinical outcomes of each group were comprehensively analyzed.

The main cause of HLH was infection (35/43 cases), with EB virus infection (15/35 cases) and leishmania (13/35 cases) being the most common. In the leishmania and EB virus infection group, the average of alanine aminotransferase (ALT) levels were 81 U/L and 87 U/L respectively, were higher than other infection group (P < 0.05). The average of procalcitonin (PCT) levels were 2.88 ng/mL, 4.37 ng/mL respectively in the Leishmania group and other infection group, were higher than EBV infection group(0.43 ng/mL). The average of D-dimer (D-D) levels were statistically significant differences among Leishmania group(2.31 mg/dL), EBV infection group(2.12 mg/dL) and the other infection group (3.34 ng/mL). The leishmania group had a cure rate of 100% (13/13), while the EB virus infection group had a cure rate of 26.67% (4/15).

Leishmania and EB virus infection are common causes of HLH in Gansu Province. Compared to HLH caused by other factors such as EB virus infection or autoimmune diseases, the prognosis of HLH in children with leishmania infection is relatively better.

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