Diagnosis of Lymphohistiocytic Hemophagocytosis in Intensive Care

University Hospital, Strasbourg, France100 enrolled

Overview

Patients with hepatocellular insufficiency and/or cirrhosis are at risk of developing invasive fungal infections, particularly in critical care settings. In international recommendations, voriconazole is positioned as the first-line treatment for invasive aspergillosis. However, this molecule-and the azole class of antifungals-is associated with frequent hepatic toxicity. Available since 2018, isavuconazole appears to be better tolerated in patients without pre-existing liver dysfunction. The aim of this study is to retrospectively evaluate the validity of the hscore in intensive care and resuscitation patients.

Study Type

OBSERVATIONAL

Enrollment

100

Conditions

Hepatic Insufficiency Cirrhosis, Liver

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Adult patient (≥18 years old) * Patient admitted to the intensive care unit at Hautepierre Hospital, Strasbourg University Hospital, between January 1, 2014, and December 31, 2024 * At least 3 biological signs of HLH: * ferritin \> 2000 ng/mL * triglycerides \> 1.5 g/L * at least one cytopenia (leukocytes ≤ 5000 G/L, platelets ≤ 110 G/L, hemoglobin ≤ 9.2 g/dL). Exclusion Criteria: Refusal to participate in the study

Locations (1)

Outcomes

Primary Outcomes

hscore

The HScore adds up points assigned to 9 clinical, biological, and histological criteria: The higher the total score, the greater the likelihood of HLH: Possible total score: 0 to 337: HScore: Probability of HLH: \< 90 points → Very low * 130 points → ≈ 10-20% 168 points → high probability of HL

Time frame: Up to 12 months