Hepatic sinusoidal hemophagocytosis with and without hemophagocytic lymphohistiocytosis.
<h4>Background/purpose</h4>Hemophagocytic lymphohistiocytosis (HLH) is a rare, life threatening hyperinflammatory syndrome. Sinusoidal hemophagocytosis is occasionally observed on liver biopsy in patients who do not have clinical suspicion of HLH. We aimed at comparing the clinical chara...
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2019-01-01
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| Series: | PLoS ONE |
| Online Access: | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0226899&type=printable |
| _version_ | 1826574195392249856 |
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| author | Jacqueline De Gottardi Matteo Montani Anne Angelillo-Scherrer Alicia Rovo Annalisa Berzigotti |
| author_facet | Jacqueline De Gottardi Matteo Montani Anne Angelillo-Scherrer Alicia Rovo Annalisa Berzigotti |
| author_sort | Jacqueline De Gottardi |
| collection | DOAJ |
| description | <h4>Background/purpose</h4>Hemophagocytic lymphohistiocytosis (HLH) is a rare, life threatening hyperinflammatory syndrome. Sinusoidal hemophagocytosis is occasionally observed on liver biopsy in patients who do not have clinical suspicion of HLH. We aimed at comparing the clinical characteristics and outcomes of patients with signs of hemophagocytosis on liver biopsy meeting and not meeting the HLH diagnostic criteria.<h4>Methods</h4>We reviewed the clinical, laboratory features and outcomes of all adult patients consecutively admitted in our center between 08/2011 and 08/2017 presenting with liver histology showing sinusoidal hemophagocytosis and of critically ill patients presenting with severe liver disease in whom hemophagocytosis was histologically confirmed. The characteristics of patients fulfilling and not fulfilling the diagnostic criteria of HLH were compared.<h4>Results</h4>We identified 12 cases (58% male, median age 61, 75% with a chronic underlying disease) with liver histology showing sinusoidal hemophagocytosis. All had at least some of the clinical features typically associated with HLH. Six were critical ill patients. In 4 cases with insufficient laboratory and clinical criteria, liver biopsy allowed to confirm the HLH diagnosis. Six patients died, of which four met the diagnostic criteria for HLH. Two patients with chronic liver disease died despite not fulfilling the diagnostic criteria of HLH.<h4>Conclusion</h4>Hemophagocytosis on liver biopsy may contribute to confirming a diagnosis of HLH in suspected cases with indeterminate clinical and laboratory findings. Sinusoidal hemophagocytosis in patients with cirrhosis was associated with bad outcome. |
| first_indexed | 2024-12-20T02:39:06Z |
| format | Article |
| id | doaj.art-22820bb2cbf247a2ba7adda8d4a83b86 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2025-03-14T12:54:57Z |
| publishDate | 2019-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-22820bb2cbf247a2ba7adda8d4a83b862025-03-02T05:33:40ZengPublic Library of Science (PLoS)PLoS ONE1932-62032019-01-011412e022689910.1371/journal.pone.0226899Hepatic sinusoidal hemophagocytosis with and without hemophagocytic lymphohistiocytosis.Jacqueline De GottardiMatteo MontaniAnne Angelillo-ScherrerAlicia RovoAnnalisa Berzigotti<h4>Background/purpose</h4>Hemophagocytic lymphohistiocytosis (HLH) is a rare, life threatening hyperinflammatory syndrome. Sinusoidal hemophagocytosis is occasionally observed on liver biopsy in patients who do not have clinical suspicion of HLH. We aimed at comparing the clinical characteristics and outcomes of patients with signs of hemophagocytosis on liver biopsy meeting and not meeting the HLH diagnostic criteria.<h4>Methods</h4>We reviewed the clinical, laboratory features and outcomes of all adult patients consecutively admitted in our center between 08/2011 and 08/2017 presenting with liver histology showing sinusoidal hemophagocytosis and of critically ill patients presenting with severe liver disease in whom hemophagocytosis was histologically confirmed. The characteristics of patients fulfilling and not fulfilling the diagnostic criteria of HLH were compared.<h4>Results</h4>We identified 12 cases (58% male, median age 61, 75% with a chronic underlying disease) with liver histology showing sinusoidal hemophagocytosis. All had at least some of the clinical features typically associated with HLH. Six were critical ill patients. In 4 cases with insufficient laboratory and clinical criteria, liver biopsy allowed to confirm the HLH diagnosis. Six patients died, of which four met the diagnostic criteria for HLH. Two patients with chronic liver disease died despite not fulfilling the diagnostic criteria of HLH.<h4>Conclusion</h4>Hemophagocytosis on liver biopsy may contribute to confirming a diagnosis of HLH in suspected cases with indeterminate clinical and laboratory findings. Sinusoidal hemophagocytosis in patients with cirrhosis was associated with bad outcome.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0226899&type=printable |
| spellingShingle | Jacqueline De Gottardi Matteo Montani Anne Angelillo-Scherrer Alicia Rovo Annalisa Berzigotti Hepatic sinusoidal hemophagocytosis with and without hemophagocytic lymphohistiocytosis. PLoS ONE |
| title | Hepatic sinusoidal hemophagocytosis with and without hemophagocytic lymphohistiocytosis. |
| title_full | Hepatic sinusoidal hemophagocytosis with and without hemophagocytic lymphohistiocytosis. |
| title_fullStr | Hepatic sinusoidal hemophagocytosis with and without hemophagocytic lymphohistiocytosis. |
| title_full_unstemmed | Hepatic sinusoidal hemophagocytosis with and without hemophagocytic lymphohistiocytosis. |
| title_short | Hepatic sinusoidal hemophagocytosis with and without hemophagocytic lymphohistiocytosis. |
| title_sort | hepatic sinusoidal hemophagocytosis with and without hemophagocytic lymphohistiocytosis |
| url | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0226899&type=printable |
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