{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T21:15:38Z","timestamp":1760044538543},"reference-count":30,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2013,5,17]],"date-time":"2013-05-17T00:00:00Z","timestamp":1368748800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Journal of Forensic Sciences"],"published-print":{"date-parts":[[2013,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The hemophagocytic lymphohistiocytosis (<jats:styled-content style=\"fixed-case\">HLH<\/jats:styled-content>) syndrome is a hyperimmune disorder characterized by lymphohistiocytic infiltrations, elevated cytokine levels in the blood, macrophage activation, and hemophagocytosis, frequently presenting with a febrile septic picture. This unusual disease is more common in infancy and childhood than adulthood. It is classified as primary or familial when a genetic defect is identified and secondary or acquired when triggered by certain infections, autoimmune disorders, or malignancies. If or when such patients expire, they typically do so within a hospital or under a physician's care and so such cases rarely come to the attention of forensic pathologists. We report on the unexpected deaths of two hospitalized adult cases of <jats:styled-content style=\"fixed-case\">HLH<\/jats:styled-content> brought to autopsy without a premortem diagnosis. Postmortem examination demonstrated marked hepatosplenomegaly and lymphadenopathy in association with hemophagocytosis. Although very uncommon <jats:styled-content style=\"fixed-case\">HLH<\/jats:styled-content> must be considered in infants, children, or adults who die unexpectedly with an undiagnosed septic presentation.<\/jats:p>","DOI":"10.1111\/1556-4029.12131","type":"journal-article","created":{"date-parts":[[2013,5,17]],"date-time":"2013-05-17T20:35:07Z","timestamp":1368822907000},"page":"1080-1084","source":"Crossref","is-referenced-by-count":4,"title":["Sudden Unexpected Death due to Hemophagocytic Lymphohistiocytosis Syndrome"],"prefix":"10.1111","volume":"58","author":[{"given":"Dennis J.","family":"Chute","sequence":"first","affiliation":[{"name":"Dutchess County Medical Examiner's Office 387 Main Street Poughkeepsie NY 12601"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James","family":"Rawley","sequence":"additional","affiliation":[{"name":"Dutchess County Medical Examiner's Office 387 Main Street Poughkeepsie NY 12601"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Cox","sequence":"additional","affiliation":[{"name":"Dutchess County Medical Examiner's Office 387 Main Street Poughkeepsie NY 12601"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert J.","family":"Bready","sequence":"additional","affiliation":[{"name":"Dutchess County Medical Examiner's Office 387 Main Street Poughkeepsie NY 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