Successful treatment of hemophagocytic lymphohistiocytosis in a trauma patient: a case report

Hemophagocytic lymphohistiocytosis (HLH) is a rare, life-threatening hyperinflammatory syndrome characterized by excessive activation of the immune system. This case report describes an unusual presentation of HLH triggered by severe trauma from a motorcycle accident, which is a departure from tradi...

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Main Authors: Young Soo Chung, Jihoon Kim
Format: Article
Language:English
Published: Korean Society of Traumatology 2025-03-01
Series:Journal of Trauma and Injury
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Online Access:http://jtraumainj.org/upload/pdf/jti-2024-0093.pdf
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author Young Soo Chung
Jihoon Kim
author_facet Young Soo Chung
Jihoon Kim
author_sort Young Soo Chung
collection DOAJ
description Hemophagocytic lymphohistiocytosis (HLH) is a rare, life-threatening hyperinflammatory syndrome characterized by excessive activation of the immune system. This case report describes an unusual presentation of HLH triggered by severe trauma from a motorcycle accident, which is a departure from traditional associations with infections, malignancies, or autoimmune conditions. A 40-year-old man with multiple traumatic injuries developed persistent fever, pancytopenia, and elevated inflammatory markers following orthopedic surgery. Despite empiric antibiotic therapy, his condition deteriorated, exhibiting high fever, skin rash, hepatic dysfunction, and marked elevation of ferritin levels (32,901 ng/mL). Bone marrow biopsy confirmed the diagnosis of HLH, and treatment was initiated according to the HLH-2004 protocol, which included methylprednisolone, intravenous immunoglobulin, and immunosuppressive therapy. The patient demonstrated significant clinical improvement and was discharged after 37 days, with no recurrence observed during the follow-up period. This case underscores the need to consider HLH in trauma patients presenting with unexplained inflammatory responses and illustrates that prompt diagnosis and aggressive treatment can lead to successful outcomes.
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spelling doaj-art-b0b318995be345d59334d72e41cc657d2025-08-20T01:55:10ZengKorean Society of TraumatologyJournal of Trauma and Injury2799-43172287-16832025-03-01381667010.20408/jti.2024.00931341Successful treatment of hemophagocytic lymphohistiocytosis in a trauma patient: a case reportYoung Soo Chung0Jihoon Kim1 Department of Surgery, Dong-A University Hospital, Dong-A University College of Medicine, Busan, Korea Department of Trauma Surgery, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, KoreaHemophagocytic lymphohistiocytosis (HLH) is a rare, life-threatening hyperinflammatory syndrome characterized by excessive activation of the immune system. This case report describes an unusual presentation of HLH triggered by severe trauma from a motorcycle accident, which is a departure from traditional associations with infections, malignancies, or autoimmune conditions. A 40-year-old man with multiple traumatic injuries developed persistent fever, pancytopenia, and elevated inflammatory markers following orthopedic surgery. Despite empiric antibiotic therapy, his condition deteriorated, exhibiting high fever, skin rash, hepatic dysfunction, and marked elevation of ferritin levels (32,901 ng/mL). Bone marrow biopsy confirmed the diagnosis of HLH, and treatment was initiated according to the HLH-2004 protocol, which included methylprednisolone, intravenous immunoglobulin, and immunosuppressive therapy. The patient demonstrated significant clinical improvement and was discharged after 37 days, with no recurrence observed during the follow-up period. This case underscores the need to consider HLH in trauma patients presenting with unexplained inflammatory responses and illustrates that prompt diagnosis and aggressive treatment can lead to successful outcomes.http://jtraumainj.org/upload/pdf/jti-2024-0093.pdflymphohistiocytosishemophagocyticmultiple traumaferritinscase reports
spellingShingle Young Soo Chung
Jihoon Kim
Successful treatment of hemophagocytic lymphohistiocytosis in a trauma patient: a case report
Journal of Trauma and Injury
lymphohistiocytosis
hemophagocytic
multiple trauma
ferritins
case reports
title Successful treatment of hemophagocytic lymphohistiocytosis in a trauma patient: a case report
title_full Successful treatment of hemophagocytic lymphohistiocytosis in a trauma patient: a case report
title_fullStr Successful treatment of hemophagocytic lymphohistiocytosis in a trauma patient: a case report
title_full_unstemmed Successful treatment of hemophagocytic lymphohistiocytosis in a trauma patient: a case report
title_short Successful treatment of hemophagocytic lymphohistiocytosis in a trauma patient: a case report
title_sort successful treatment of hemophagocytic lymphohistiocytosis in a trauma patient a case report
topic lymphohistiocytosis
hemophagocytic
multiple trauma
ferritins
case reports
url http://jtraumainj.org/upload/pdf/jti-2024-0093.pdf
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AT jihoonkim successfultreatmentofhemophagocyticlymphohistiocytosisinatraumapatientacasereport