Impressing ๐พ๐ค๐ฃ๐จ๐ช๐ก๐ฉ๐๐ฃ๐ฉ ๐ค๐ฃ ๐๐ค๐ช๐ฃ๐ โ
Residents use the fancy diagnosis and terms like
๐๐๐ - Hemophagocytic lymphohistiocytosis
A ๐งต on what is ๐๐๐ and how to diagnose it
#MedTwitter
#HLH
#MedEd
#usmle
Residents use the fancy diagnosis and terms like
๐๐๐ - Hemophagocytic lymphohistiocytosis
A ๐งต on what is ๐๐๐ and how to diagnose it
#MedTwitter
#HLH
#MedEd
#usmle
๐Hyperinflammatory syndrome caused by โฌ๏ธcytokine release
๐ Either due to genetic or acquired overactivation of CD8 T cells and natural killer (NK) cells
โด๏ธ Hemophagocytosis is neither sensitive nor specific for HLH
๐ ฒ๐ ป๐ ฐ๐๐๐ ธ๐ ต๐ ธ๐ ฒ๐ ฐ๐๐ ธ๐ พ๐ ฝ ๐
๐ Either due to genetic or acquired overactivation of CD8 T cells and natural killer (NK) cells
โด๏ธ Hemophagocytosis is neither sensitive nor specific for HLH
๐ ฒ๐ ป๐ ฐ๐๐๐ ธ๐ ต๐ ธ๐ ฒ๐ ฐ๐๐ ธ๐ พ๐ ฝ ๐
Lets discuss one of the ๐๐๐๐ ๐๐๐๐๐๐๐๐๐ that came to AIIMS:
24,๐, without any Co-morbidties
C/O Fever, Malaise, Sore throat, Headache
๐๐ง ๐๐ฑ๐๐ฆ๐ข๐ง๐๐ญ๐ข๐จ๐ง :
๐ธHR ~125/min ๐บ
๐ธSevere Pallor
๐ธCervical Lymphadenopathy
๐ธPetechial Rash
Investigation๐
24,๐, without any Co-morbidties
C/O Fever, Malaise, Sore throat, Headache
๐๐ง ๐๐ฑ๐๐ฆ๐ข๐ง๐๐ญ๐ข๐จ๐ง :
๐ธHR ~125/min ๐บ
๐ธSevere Pallor
๐ธCervical Lymphadenopathy
๐ธPetechial Rash
Investigation๐
Peripheral Smear ๐ - Atypical lymphocytes {Downey Cells}
๐Palpable enlarged spleen
๐ Ctyopenias Worsening
๐ TG - 402 ๐
๐ Ferritin - 3K๐
After suspicion of ๐๐๐ฉ, PCR was sent which came out to be โve โ๏ธ
A Diagnosis of 2' ๐๐๐ was made
๐Palpable enlarged spleen
๐ Ctyopenias Worsening
๐ TG - 402 ๐
๐ Ferritin - 3K๐
After suspicion of ๐๐๐ฉ, PCR was sent which came out to be โve โ๏ธ
A Diagnosis of 2' ๐๐๐ was made
๐๐ข๐๐ ๐ง๐จ๐ฌ๐ข๐ฌ : Challenging
๐ธNonspecific symptoms
๐ธOverlapping features with sepsis and hematologic malignancy
๐ธSame disorders can trigger HLH
๐ ฑ๐๐
Essential as without Rx, ๐๐๐ is FATAL๐ด
๐ฟ๐๐๐๐ฃ๐ค๐จ๐ฉ๐๐ ๐พ๐ง๐๐ฉ๐๐ง๐๐ ๐
๐ธNonspecific symptoms
๐ธOverlapping features with sepsis and hematologic malignancy
๐ธSame disorders can trigger HLH
๐ ฑ๐๐
Essential as without Rx, ๐๐๐ is FATAL๐ด
๐ฟ๐๐๐๐ฃ๐ค๐จ๐ฉ๐๐ ๐พ๐ง๐๐ฉ๐๐ง๐๐ ๐
๐
ท - ๐๐
ฒ๐
พ๐๐
ด
๐Retrospective data of 312 adult population with non-familial HLH was used to design the score
๐The best cutoff value: 169 (Sn-93%, Sp-86%)
๐ธ"HLH-2004 criteria" > H-Score - ๐๐ถ๐บ๐ถ๐น๐ฎ๐ฟ ๐๐ฒ๐ป๐๐ถ๐๐ถ๐๐ถ๐๐ ๐ฏ๐๐ ๐ต๐ถ๐ด๐ต๐ฒ๐ฟ ๐๐ฝ๐ฒ๐ฐ๐ถ๐ณ๐ถ๐ฐ๐ถ๐๐
๐Retrospective data of 312 adult population with non-familial HLH was used to design the score
๐The best cutoff value: 169 (Sn-93%, Sp-86%)
๐ธ"HLH-2004 criteria" > H-Score - ๐๐ถ๐บ๐ถ๐น๐ฎ๐ฟ ๐๐ฒ๐ป๐๐ถ๐๐ถ๐๐ถ๐๐ ๐ฏ๐๐ ๐ต๐ถ๐ด๐ต๐ฒ๐ฟ ๐๐ฝ๐ฒ๐ฐ๐ถ๐ณ๐ถ๐ฐ๐ถ๐๐
Investigations to be sent ๐
๐๐ง๐๐ข๐๐๐ญ๐ข๐จ๐ง๐ฌ ๐จ๐ ๐๐๐ง๐๐ญ๐ข๐ ๐๐๐ฌ๐ญ๐ข๐ง๐
๐ธEarlier onset
๐ธRecurrent HLH
๐ธRefractory HLH
๐ธFamily History
๐ธConsanguinity
๐ธAlbinism
๐ธWithout an apparent trigger or predisposing disease
๐ธEarlier onset
๐ธRecurrent HLH
๐ธRefractory HLH
๐ธFamily History
๐ธConsanguinity
๐ธAlbinism
๐ธWithout an apparent trigger or predisposing disease
Hope you find it useful๐
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