Hemophagocytic lymphohistiocytosis in adults (HLH) is at 68% mortality whereas 78% of all cases remain undiagnosed though therapies are available which clearly reduce mortality. The investigators aim to systematically investigate this life-threatening hyperinflammatory syndrome in intensive care units (ICU) in order to detect biomarkers that are highly sensitive and highly specific for HLH in ICU compared to patients with sepsis.
The investigators will draw blood samples of 100 patients at the time of diagnosis (each 50 with suspected or diagnosed HLH/sepsis) to determine a cytokine panel (c reactive protein (CRP), procalcitonin (PCT), interleukin (IL) 1β, IL-6, IL-8, IL-10, IL-18, IL-33, tumor necrosis factor (TNF) α, interferon (IFN) ɣ, soluble IL-2 receptor (sIL-2R), the EBV and CMV viral loads, human immunodeficiency virus (HIV) antibodies and -antigen, perforin, fibrinogen, triglycerides, bilirubin, lactate dehydrogenase, liver transaminases, sodium, serum albumin, electrophoresis, glycosylated ferritin, the microRNAs miR-205-5p, miR-194-5p and miR-30c-5p, perforin, CD107a and high immune status (differential blood count, T cells, B cells, NK cells, T helper cells, cytotoxic T cells, CD4 / CD8 ratio, HLA-DR of CD8 +, CD11a of CD8, CD57 of CD8, CD28 of CD8 +, HLA-DR of monocytes, CD56bright and CD69 of NK cells). The results of this study serve the development of new clinical concepts in order to safely diagnose HLH at an early stage, to distinguish from sepsis and to reduce the fatal consequences.
Study Type
OBSERVATIONAL
Enrollment
100
Department of Anesthesiology and Operative Intensive Care Medicine (CCM, CVK), Charité - Universitätsmedizin Berlin
Berlin, Germany
Incidence of HLH in intensive care units based on HLH-2004 criteria
HLH patients are followed up until the end of hospital stay or death.
Time frame: Up to 180 days
Intensive care unit stay
Time frame: Participants will be followed up for the duration of hospital length of stay, an expected average of 4 weeks
Hospital stay
Time frame: Participants will be followed up for the duration of hospital length of stay, an expected average of 8 weeks
Mortality
Mortality after 30 and 180 days
Time frame: Up to 180 days
Cytokine panel
1 blood sample of Cytokine panel (CRP, PCT, IL-1β, IL-6, IL-8, IL-10, IL-18, IL-33, TNF-α, IFN-ɣ, sIL-2R, ferritin) collection at time of diagnosed HLH
Time frame: Up to 180 days
Epstein Barr Virus (EBV) and Cytomegalovirus (CMV) viral loads
1 blood sample collection at time of diagnosed HLH
Time frame: Up to 180 days
Glycosylated ferritin
1 blood sample collection at time of diagnosed HLH
Time frame: Up to 180 days
microRNAs miR-205-5p, miR-194-5p and miR-30c-5p
1 blood sample collection at time of diagnosed HLH
Time frame: Up to 180 days
Perforin and CD107a
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.
1 blood sample collection at time of diagnosed HLH
Time frame: Up to 180 days
Human immunodeficiency virus antibodies and -antigen
1 blood sample collection at time of diagnosed HLH
Time frame: Up to 180 days
Fibrinogen
Time frame: Up to 180 days
Triglycerides
Time frame: Up to 180 days
Bilirubin
Time frame: Up to 180 days
Lactate dehydrogenase
Lactate dehydrogenase is measured in U/l
Time frame: Up to 180 days
Liver transaminase (ASAT)
ASAT \[U/l\]
Time frame: Up to 180 days
Liver transaminases (ALAT)
ALAT \[U/l\]
Time frame: Up to 180 days
Sodium
Time frame: Up to 180 days
Serum albumin
Time frame: Up to 180 days
Serum protein electrophoresis
Serum protein Electrophoresis (%) is used to separate and quantify the serum protein components into serum albumin, alpha-1 globulins, alpha-2 globulins, beta 1 and 2 globulins, and gamma Globulins.
Time frame: Up to 180 days
Detailed immune status
The immune status is analyzed by differential blood count \[/nl\], T cells \[/nl\], B cells \[/nl\], NK cells \[/nl\], T helper cells \[/nl\], cytotoxic T cells \[/nl\], CD4 / CD8 ratio, HLA-DR of CD8+ \[%\], CD11a of CD8 \[%\], CD57 of CD8 \[%\], CD28 of CD8+ \[%\], HLA-DR of monocytes \[antigen/cell\], CD56bright \[%\] and CD69 \[%\] of NK cells.
Time frame: Up to 180 days