Tian Fangbing, Xie Nana, Sun Wenjin, Zhang Wencong, Zhang Wenyuan, Chen Jia, Ruan Qiurong, Song Jianxin
Department of Infectious Diseases, Tongji Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China.
Department of Infectious Diseases, Ezhou Central Hospital, Ezhou, People's Republic of China.
Int J Gen Med. 2025 Jan 22;18:321-330. doi: 10.2147/IJGM.S504345. eCollection 2025.
Hemophagocytic lymphohistiocytosis (HLH) is a critical syndrome with a high mortality rate. In clinical practice, some patients with fever of unknown origin (FUO) can develop HLH, further complicating the diagnosis and treatment. However, studies on HLH in adults with FUO are limited. This study aimed to investigate the clinical characteristics of adult patients with FUO to facilitate the early identification of those at high risk of developing HLH.
We collected data from hospitalized patients with FUO between January 2014 and December 2020. Risk factors for HLH in adults with FUO were analyzed using univariate and multivariate analysis.
A total of 988 patients with FUO were included in the study. The incidence of HLH in adults with FUO was 6.4%, with hematological tumors being the primary cause. Multivariate analysis indicated that skin rash and elevated alanine aminotransferase, total bilirubin, triglycerides, lactate dehydrogenase, and ferritin levels were independent risk factors for HLH in adults with FUO.
This study revealed the incidence rate, etiology distribution, and risk factors for HLH in adults with FUO. Comprehensive assessment of clinical and laboratory data at admission can assist in the early identification of FUO patients at risk for HLH.
噬血细胞性淋巴组织细胞增生症（HLH）是一种死亡率很高的严重综合征。在临床实践中，一些不明原因发热（FUO）患者可发展为HLH，这进一步使诊断和治疗复杂化。然而，关于成人FUO合并HLH的研究有限。本研究旨在调查成人FUO患者的临床特征，以促进对有发展为HLH高风险患者的早期识别。
我们收集了2014年1月至2020年12月期间住院的FUO患者的数据。采用单因素和多因素分析方法分析成人FUO患者发生HLH的危险因素。
本研究共纳入988例FUO患者。成人FUO患者中HLH的发生率为6.4%，血液系统肿瘤是主要病因。多因素分析表明，皮疹以及丙氨酸转氨酶、总胆红素、甘油三酯、乳酸脱氢酶和铁蛋白水平升高是成人FUO患者发生HLH的独立危险因素。
本研究揭示了成人FUO患者中HLH的发生率、病因分布及危险因素。入院时对临床和实验室数据进行综合评估有助于早期识别有HLH风险的FUO患者。
