{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,24]],"date-time":"2025-09-24T14:10:26Z","timestamp":1758723026608,"version":"3.44.0"},"reference-count":26,"publisher":"Springer Science and Business Media LLC","issue":"5","license":[{"start":{"date-parts":[[2025,4,22]],"date-time":"2025-04-22T00:00:00Z","timestamp":1745280000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,4,22]],"date-time":"2025-04-22T00:00:00Z","timestamp":1745280000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Manipal Academy of Higher Education - Kasturba Medical College, Mangalore"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Infection"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Purpose<\/jats:title>\n            <jats:p>Haemophagocytic lymphohistiocytosis (HLH) is a rare, life-threatening disorder. Dengue fever is a common trigger for HLH in the tropics. We aimed to develop a simplified clinical tool to detect HLH in dengue patients.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>A cross-sectional observational study was carried out at Kasturba Medical College Mangalore. Patients between 18 and 60 years of age, with dengue fever for more than five days with suspected HLH symptoms were selected. Hepatosplenomegaly, temperature, haemoglobin levels, total leucocyte count, platelet count, ferritin, triglyceride, and liver function tests were assessed. HLH-2004 criteria were used to confirm the diagnosis. A simple clinical tool was developed via decision tree analysis using clinical and laboratory parameters.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Patients with HLH had marked leucopenia, thrombocytopenia, hyperferritinaemia and elevated aspartate aminotransferase levels, and a greater incidence of hepatosplenomegaly than those without HLH. Decision tree analysis was used to generate a clinical diagnostic tool, which demonstrated an accuracy of 94%, at a confidence interval of 95% (90\u201398%). The model\u2019s ability to predict HLH was 79%, while its specificity was 96%. It had a positive predictive value of 68% and a negative predictive value of 97%. The kappa value of the predicted model was 0.70, indicating an agreement with the diagnosis using HLH-2004 criteria, with a significant p-value (&lt;\u20090.001).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>Splenomegaly can be used as a screening method to diagnose HLH in patients with dengue. By using an algorithmic approach, combining splenomegaly with leucopenia and thrombocytopenia, this clinical tool accurately detects HLH in patients with dengue.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1007\/s15010-025-02542-8","type":"journal-article","created":{"date-parts":[[2025,4,22]],"date-time":"2025-04-22T08:12:25Z","timestamp":1745309545000},"page":"2037-2044","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A simple clinical tool for effective screening of haemophagocytic lymphohistiocytosis in dengue"],"prefix":"10.1007","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-0253-2234","authenticated-orcid":false,"given":"Jeco Jacob","family":"Kuttykandathil","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-3185-1921","authenticated-orcid":false,"given":"Arfath","family":"Ahmed","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-8033-8171","authenticated-orcid":false,"given":"Gauri Malavalli","family":"Girish","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chyavan Trisule Reddy","family":"Tummaluru","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vivek Kothandaraman","family":"Koushik","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tapendu","family":"Patoary","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0460-7913","authenticated-orcid":false,"given":"Chakrapani","family":"Mahabala","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,4,22]]},"reference":[{"key":"2542_CR1","doi-asserted-by":"crossref","unstructured":"Jones NK, Yacoub S. Dengue. In: Farrar J, editor. Manson\u2019s Tropical Diseases. 24th ed. Elsevier; 2024, pp. 202\u201311. Available from: https:\/\/www.clinicalkey.com\/service\/content\/pdf\/watermarked\/3-s2.0-B978070207959700021X.pdf?locale=en_US%26searchIndex","DOI":"10.1016\/B978-0-7020-7959-7.00021-X"},{"key":"2542_CR2","unstructured":"Severe Dengue. Know the Warning Signs| Dengue| CDC [Internet]. [cited 2024 Aug 12]. Available from: https:\/\/www.cdc.gov\/dengue\/stories\/severe-dengue.html#"},{"key":"2542_CR3","unstructured":"DENGUE SITUATION IN INDIA: National Center for Vector Borne Diseases. Control (NCVBDC) [Internet]. [cited 2024 Sep 15]. Available from: https:\/\/ncvbdc.mohfw.gov.in\/index4.php?lang=1%26level=0%26linkid=431%26lid=3715"},{"key":"2542_CR4","unstructured":"Saker L, Lee K, Cannito B, Gilmore A, Campbell-Lendrum D. Globalization and infectious diseases: A review of the linkages. 2004."},{"key":"2542_CR5","doi-asserted-by":"crossref","unstructured":"Balogun EO, Nok AJ, Kita K. Global warming and the possible globalization of vector-borne diseases: A call for increased awareness and action. Tropical Medicine and Health. Volume 44. BioMed Central Ltd.; 2016.","DOI":"10.1186\/s41182-016-0039-0"},{"issue":"10","key":"2542_CR6","doi-asserted-by":"publisher","first-page":"198","DOI":"10.14745\/ccdr.v42i10a02","volume":"42","author":"M Kulkarni","year":"2016","unstructured":"Kulkarni M. Global spread and impacts of emerging vector-borne diseases. Can Commun Dis Rep. 2016;42(10):198\u20139.","journal-title":"Can Commun Dis Rep"},{"key":"2542_CR7","doi-asserted-by":"crossref","unstructured":"Bhatia S, Bansal D, Patil S, Pandya S, Ilyas QM, Imran S. A retrospective study of climate change affecting dengue: evidences, challenges and future directions. Front Public Health. 2022;10.","DOI":"10.3389\/fpubh.2022.884645"},{"key":"2542_CR8","doi-asserted-by":"publisher","unstructured":"Sophia Y, Koll M, 1\u2217 R, Murtugudde R, Karipot A, Sapkota A et al. 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(Ethics approval reference number: IEC KMC MLR 09\u201316\/228)","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"Informed consent was obtained from all individual participants included in the study.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}},{"value":"Patients signed informed consent regarding publishing their data.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to publication"}},{"value":"The authors declare no competing interests.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}]}}