Hemophagocytic lymphohistiocytosis in critically ill patients: A guide for clinicians

doi:10.5492/wjccm.120840

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World Journal of Critical Care Medicine

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2220-3141

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Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Crit Care Med. Sep 9, 2026; 15(3): 120840
Published online Sep 9, 2026. doi: 10.5492/wjccm.120840

Table 1 Triggers for secondary haemophagocytic lymphohistiocytosis

Infective triggers	Non-infective triggers
Viral	Auto-immune diseases, Crohn disease, sJIA, adult-onset Still’s disease, systemic lupus erythematosus, rheumatoid arthritis, systemic vasculitides, polymyositis, dermatomyositis
Epstein-Barr virus
HIV
Parvovirus B19
CMV, HSV, HHV-6, VZV
Adenovirus
SARS-Cov-2 virus
Influenza A and B
Dengue virus
Bacterial	Malignancy related, lymphomas, monoclonal antibodies therapy, CAR-T therapies, ibrutinib
Mycobacteria spp.
Rickettsia spp.
Legionella spp.
Staphylococcus spp.
Escherichia coli
Protozoan	Hematopoietic stem cell transplantation, solid organ transplantation
Leishmania spp.
Plasmodium spp.
Toxoplasma spp.
Fungal	Drug-induced: Anticonvulsivants (lamotrigine, phenytoin, carbamazepine), antimicrobials (penicillins, cephalosporines), alemtuzumab
Histoplasma
Pneumocystis jiroveci
Candida spp.
Aspergillus spp.
Sepsis

CAR-T: Chimeric-antigen receptor T-cell; CMV: Cytomegalovirus; HHV-6: Human herpesvirus 6; HIV: Human immunodeficiency virus; HSV: Herpes simplex virus; sHLH: Secondary haemophagocytic lymphohistiocytosis; sJIA: Systemic juvenile idiopathic arthritis; VZV: Varicella zoster virus; SARS-Cov-2: Severe acute respiratory distress syndrome corona virus-2.

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Citation: Nedel W. Hemophagocytic lymphohistiocytosis in critically ill patients: A guide for clinicians. World J Crit Care Med 2026; 15(3): 120840
URL: https://www.wjgnet.com/2220-3141/full/v15/i3/120840.htm
DOI: https://dx.doi.org/10.5492/wjccm.120840

Nedel W. Hemophagocytic lymphohistiocytosis in critically ill patients: A guide for clinicians. World J Crit Care Med 2026; 15(3): 120840 [DOI: 10.5492/wjccm.120840]

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