A Retrospective Analysis of Dengue-associated Hemophagocytic Lymphohistiocytosis in a Dengue-endemic Country
Daniel De Zubiría Posada·Manuela Olaya Hernandez·Jacobo Triviño Arias·Oriana Arias Valderrama·Diego Medina Valencia·Mario Alejandro Bustos-Paz·Sofía Martínez Betancur·Alexis Antonio Franco Moreno·Pamela Andrea Rodríguez Riveros·Luz Ángela Urcuqui Bustamante·María Ximena Castro García·Jaime Alberto Patiño Niño·Paola Marsela Pérez Camacho·Viviana Lotero Díaz·Harry Mauricio Pachajoa Londoño·Vanessa Cabrera Guarín
DA-HLH should be considered in pediatric patients with dengue who present with persistent fever, cytopenias, hepatic dysfunction and marked hyperferritinemia. In this exploratory analysis, elevated bilirubin appeared to reflect severe systemic and hepatic involvement rather than an independent prognostic factor, while viral coinfections may contribute to disease severity. Early recognition and individualized immunomodulatory management are essential, and larger multicenter studies are needed to