Clinical Characteristics and Outcomes of Pediatric Hemophagocytic Lymphohistocytosis: A Retrospective Study from a Tertiary Center in Jordan
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Rahaf Jadee’ Bakheet Alhasan
,
Hebah Yousef Alraiqib
,
Basheer Alghizzawi
,
Abdelrahman Al-Sweedan
,
Suleimman Al-Sweedan
Abstract
caused by uncontrolled activation of macrophages and cytotoxic T cells. It is frequently underdiagnosed, leading to significant morbidity and mortality in pediatric populations. Early identification and treatment are critical to improving prognosis.
Materials and Methods: This retrospective study analyzed demographic, clinical, and laboratory data of pediatric patients aged 0 to 18 years diagnosed with HLH according to the HLH-2004 criteria. Patients admitted to our center between February 2021 and February 2023 were included. We aimed to describe common presenting symptoms, laboratory abnormalities , treatment modalities, and patient outcomes.
Results: A total of 35 children diagnosed with HLH were included; 51% were female. The mean age was 6.1 years, with an age range from birth to 18 years. Fever was the most frequent presenting symptom, reported in 85% of cases. Hemophagocytosis in bone marrow aspirates was detected in 41% of patients. The overall mortality rate was 11%. Notably, 20% of patients tested positive for anti-COVID-19 IgG antibodies, suggesting a possible temporal association with the development of HLH, Comparative analysis indicated that deceased patients had significantly lower fibrinogen levels (p = 0.04) and higher triglyceride levels (p = 0.03). Treatment regimens varied according to clinical presentation and severity.
Conclusion: HLH remains a challenging diagnosis due to its variable presentation and potential to rapidly progress to life-threatening immune activation. Prompt recognition and timely initiation of appropriate therapy are vital for improving outcomes in affected children. Increased awareness among clinicians and early intervention can reduce morbidity and mortality associated with this condition.
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| Issue | Vol 20 No 1 (2026): Articles In Press | |
| Section | Original Article(s) | |
| Keywords | ||
| Cytokine Syndrome; Fever; Hemophagocytic lymphohistiocytosis (HLH); Hypertriglyceridemia; Hypofibrinogenemia; Inflammatory Process; Pancytopenia | ||
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