Case Report
Copyright ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Nov 6, 2018; 6(13): 659-665
Published online Nov 6, 2018. doi: 10.12998/wjcc.v6.i13.659
Successful rescue of acute liver failure and hemophagocytic lymphohistiocytosis following varicella infection: A case report and review of literature
Li-Na Zhang, Wei Guo, Ji-Hong Zhu, Yang Guo
Li-Na Zhang, Department of Rheumatology and Immunology, Peking University People’s Hospital, Beijing 100044, China
Wei Guo, Ji-Hong Zhu, Yang Guo, Department of Emergency, Peking University People’s Hospital, Beijing 100044, China
Author contributions: Guo Y and Zhu JH designed the report; Guo W and Zhang LN collected the patient’s clinical data; Zhang LN analyzed the data and wrote the paper.
Supported by Capital Characteristic Clinic Project, No. Z161100000516045.
Informed consent statement: Consent was obtained from the patient and his parent for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Yang Guo, MD, Professor, Department of Emergency, Peking University People’s Hospital, 11 Xizhimen South St, Beijing 100044, China. edguoyang@163.com
Telephone: +86-10-88324690 Fax: +86-10-88324690
Received: August 7, 2018
Peer-review started: August 7, 2018
First decision: August 24, 2018
Revised: September 10, 2018
Accepted: October 9, 2018
Article in press: October 9, 2018
Published online: November 6, 2018
Core Tip

Core tip: Herein we report a case of acute liver failure (ALF) and hemophagocytic lymphohistiocytosis (HLH) induced by varicella infection, successfully rescued by a combination therapy of acyclovir and immunosuppression with dexamethasone and etoposide. Accumulating evidence pointed towards a similar immune dysregulation pattern in ALF and HLH. Given the rarity, high mortality, and complexity of HLH in the context of ALF, it is important to maintain a high suspicion for HLH in ALF with or without an identified trigger. Patients might benefit from therapies targeted to halt any underlying trigger and control the overactive immune system.