Haemophagocytic Lymphohistiocytosis: Rare, Fatal Dengue Complication Emerge In Pune Kids & Adults

A number of children along with adults in Pune have been experiencing Haemophagocytic lymphohistiocytosis (HLH) syndrome, a rare complication caused by dengue virus.

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Written By: Kinkini Gupta | Updated : July 8, 2022 1:01 PM IST

Haemophagocytic lymphohistiocytosis (HLH) syndrome induced by dengue is a complication, which is rare and life threatening. Doctors say that it is caused by an abnormal response of the body's immune system. A number of children along with adults have been experiencing this condition in Pune recently. This condition started erupting after the sudden rise in dengue cases in the cities of Maharashtra. Almost 3 to 4 patients who were infected with dengue are now admitted in the hospitals with Haemophagocytic lymphohistiocytosis (HLH) syndrome. Over the last five years, there has been a tenfold increase in cases of dengue linked HLH especially in children.

HLH can affect a persons immune system. when a person gets this condition, their immune system stops functioning normally. the white blood cells of the body, histiocytes and lymphocytes start attacking the the blood cells. Eventually the abnormal blood cells accumulate in the spleen and liver leading to enlargement of organs.

Symptoms Of HLH

Look out for the following symptoms if you have dengue fever:

  • Enlargement of your liver
  • Swollen lymph nodes
  • Skin rashes
  • Jaundice (yellow color of your skin and eyes)
  • Lung problems, including coughing and difficulty breathing
  • Digestive problems, including stomach ache, vomiting, and diarrhea
  • Nervous system problems, including headache, trouble walking, visual disturbances, and weakness

Causes Of HLH

Factors that influenced dengue induced HLH:

  • Surge in dengue virus and cases in Pune due to heavy rainfall and poor drainage system
  • Patients stopped responding to standard dengue treatment.
  • Doctors had a suspicion that their condition was different from dengue viral.

Who Is At Risk?

Both children and adults could experience this condition. Due to HLH, children might not grow up and develop normally. They could have additional symptoms such as irritability and failure to thrive or live. It could happen to infants as well as young children.

Aside from children, adults have also been falling ill with this condition. Apart from this, some are contracting the dengue virus twice. A person who is getting infected with this virus twice in a span of few months is also prone to get HLH syndrome. This is the biggest risk factor in severe dengue infection.

Treatment Options For HLH

Treatment of HLH depends on the cause, your age when the disease starts, and how severe the disease is. Some HLH are induced by cancer, and some are hereditary. Thus, the treatment can only be done according to what is causing the condition. The acquired form of HLH may clear up when your healthcare provider identifies the cause and treats the disease. HLH induced by dengue is a dangerous and fatal condition if not treated.

It would be important to differentially diagnose dengue associated HLH than HLH induced by other diseases. Experts say that early recognition and initiation of steroid treatment would be crucial for the successful treatment of dengue fever complicated by HLH.

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