Clinical and laboratory signs of haemophagocytic lymphohistiocytosis associated with pandemic influenza A(H1N1) infection in patients needing extracorporeal membrane oxygenation: A retrospective observational study

xloma.fota13 shared this article with you from Inoreader Clinical and laboratory signs of haemophagocytic lymphohistiocytosis associated with pandemic influenza A(H1N1) infection in patients needing extracorporeal membrane oxygenation: A retrospective observational study Via European Journal of Anaesthesiology (EJA) - Published Ahead-of-Print BACKGROUND Severe pandemic influenza has been associated with the hyperinflammatory condition secondary haemophagocytic lymphohistiocytosis (HLH). OBJECTIVES To determine the frequency, degree, character and possible cause of influenza-associated HLH in critically ill patients with severe acute respiratory distress syndrome due to influenza A(H1N1) infection requiring extracorporeal membrane oxygenation (ECMO) support at our hospital. DESIGN A retrospective observational study. PATIENTS AND SETTING Medical data were retrieved retrospectively from 11 consenting patients of thirteen adults infected with pandemic influenza A(H1N1) 2009 requiring ECMO between July 2009 and January 2010 at the ECMO Centre of Karolinska University Hospital, Stockholm, Sweden. All patients were evaluated for HLH using HLH-2004 criteria and HScore. RESULTS Eleven patients (median age 31 years) were included in the study and all survived. All patients showed signs of multiple organ dysfunction and pronounced inflammation, more severe in the four patients with HLH who had significantly higher peak serum concentrations of ferritin (P = 0.024), alkaline phosphatase (P = 0.012) and gamma-glutamyl transferase (P = 0.024), lower concentration of albumin (P = 0.0086) and more frequently hepatomegaly (P = 0.048). Abnormal lymphocyte cytotoxicity (lytic units View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.