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HLH is characterised by excessive inflammation and tissue destruction due to abnormal immune activation, often leading to multi-organ failure and high mortality if not promptly diagnosed and treated. Although HLH is more commonly associated with other viral infections, its occurrence with hepatitis A virus (HAV) is rare and primarily documented through case reports. The present case series aims to report the clinical presentations, diagnostic challenges, treatment strategies and outcomes of five cases of HAV-associated HLH.<\/jats:p>","DOI":"10.1177\/00494755251343390","type":"journal-article","created":{"date-parts":[[2025,6,4]],"date-time":"2025-06-04T03:57:39Z","timestamp":1749009459000},"page":"251-254","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Secondary haemophagocytic lymphohistiocytosis associated with acute viral hepatitis A \u2013 A case series"],"prefix":"10.1177","volume":"55","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9626-5243","authenticated-orcid":false,"given":"Suprabhat","family":"Giri","sequence":"first","affiliation":[{"name":"Associate Professor, Department of Gastroenterology and Hepatology, Kalinga Institute of Medical Sciences, Bhubaneswar, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-3962-6134","authenticated-orcid":false,"given":"Chandramauli","family":"Mishra","sequence":"additional","affiliation":[{"name":"Senior Resident, Department of Gastroenterology and Hepatology, Kalinga Institute of Medical Sciences, Bhubaneswar, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-7808-9216","authenticated-orcid":false,"given":"Prasanna","family":"Gore","sequence":"additional","affiliation":[{"name":"Consultant Gastroenterologist, Department of Gastroenterology, Wellness Hospital, Hyderabad, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4995-1611","authenticated-orcid":false,"given":"Dibya Lochan","family":"Praharaj","sequence":"additional","affiliation":[{"name":"Associate Professor, Department of Gastroenterology and Hepatology, Kalinga Institute of Medical Sciences, Bhubaneswar, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ramesh","family":"Uddaraju","sequence":"additional","affiliation":[{"name":"Senior Resident, Department of Gastroenterology, Institute of Medical Sciences and Sum Hospital, Bhubaneswar, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9389-1425","authenticated-orcid":false,"given":"Girish Kumar","family":"Pati","sequence":"additional","affiliation":[{"name":"Professor, Department of Gastroenterology, Institute of Medical Sciences and Sum Hospital, Bhubaneswar, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,6,4]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1007\/s40121-024-00955-w"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1007\/s40121-019-00270-9"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.diagmicrobio.2010.10.015"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofz467"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1586\/eci.09.58"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1177\/0049475519834804"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2017.08.034"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1002\/ccr3.5334"},{"key":"e_1_3_2_10_2","first-page":"7799252","article-title":"HAV infection associated with hemophagocytic syndrome","volume":"2023","author":"Aamri H","year":"2023","unstructured":"Aamri H, Elqadiry R, Nassih H, et al. HAV infection associated with hemophagocytic syndrome. 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