{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T21:48:30Z","timestamp":1781214510285,"version":"3.54.1"},"reference-count":38,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2023,1,1]],"date-time":"2023-01-01T00:00:00Z","timestamp":1672531200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Clin Med Insights Case Rep"],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Hemophagocytic lymphohistiocytosis (HLH) is a disease of multi-organ dysfunction due to excessive immune activation causing widespread inflammation and tissue destruction. It is a severe condition associated with high morbidity and mortality. Early identification is crucial for prompt treatment. The objective of this case series is to underscore the intricacy of managing HLH in individuals with renal dysfunction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This is a retrospective study of patients diagnosed with HLH in a nephrology department over a period of 30\u2009years. We retrospectively reviewed the medical files by applying the Revised HLH-2004 criteria.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Among the 14 female patients included, the mean age was 45.2\u2009years (range 23-78). Nine patients presented with sudden onset of fever and chills. Physical examination revealed purpura in 3 cases, hepatomegaly and splenomegaly in 6 and 5 cases respectively, and peripheral lymphadenopathy in 1 case. Hemorrhagic complications were observed in 5 cases, hypertriglyceridemia in 9 cases, and hyperferritinemia in all cases. Hypothyroidism was observed in all cases, and impaired renal function was detected in 11 of them, with 5 experiencing it as a result of lupus nephritis, and 1 case attributed to pre-eclampsia. Hemophagocytosis was confirmed through sternal puncture in 11 cases. Treatment involved etiological therapy with corticosteroids and immunosuppressants and\/or anti-infectives. Intravenous immunoglobulins were administered in 6 cases, while 2 cases required coagulation factor transfusions. Unfortunately, 9 patients did not survive.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>The study highlights the need for increased awareness and prompt recognition of HLH, particularly in patients with associated renal complications.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/11795476231210137","type":"journal-article","created":{"date-parts":[[2023,10,31]],"date-time":"2023-10-31T06:23:11Z","timestamp":1698733391000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Uncovering the Spectrum of Hemophagocytic Lymphohistiocytosis: A Nephrology Department\u2019s Analysis of 14 Cases"],"prefix":"10.1177","volume":"16","author":[{"given":"Meriam","family":"Hajji","sequence":"first","affiliation":[{"name":"Department of Medecine A, Charles Nicolle Hospital, Tunis, Tunisia"},{"name":"Laboratory of Nephropathology LR00SP01, Tunis, Tunisia"},{"name":"Faculty of Medicine of Tunisia, Tunis University El Manar, Tunis, Tunisia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samia","family":"Barbouch","sequence":"additional","affiliation":[{"name":"Department of Medecine A, Charles Nicolle Hospital, Tunis, Tunisia"},{"name":"Laboratory of Nephropathology LR00SP01, Tunis, Tunisia"},{"name":"Faculty of Medicine of Tunisia, Tunis University El Manar, Tunis, Tunisia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hayet","family":"Kaaroud","sequence":"additional","affiliation":[{"name":"Department of Medecine A, Charles Nicolle Hospital, Tunis, Tunisia"},{"name":"Laboratory of Nephropathology LR00SP01, Tunis, Tunisia"},{"name":"Faculty of Medicine of Tunisia, Tunis University El Manar, Tunis, Tunisia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khaoula","family":"Ben Abdelghani","sequence":"additional","affiliation":[{"name":"Department of Medecine A, Charles Nicolle Hospital, Tunis, Tunisia"},{"name":"Faculty of Medicine of Tunisia, Tunis University El Manar, Tunis, Tunisia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fethi","family":"Ben Hamida","sequence":"additional","affiliation":[{"name":"Department of Medecine A, Charles Nicolle Hospital, Tunis, Tunisia"},{"name":"Laboratory of Nephropathology LR00SP01, Tunis, Tunisia"},{"name":"Faculty of Medicine of Tunisia, Tunis University El Manar, Tunis, Tunisia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amel","family":"Harzallah","sequence":"additional","affiliation":[{"name":"Department of Medecine A, Charles Nicolle Hospital, Tunis, Tunisia"},{"name":"Laboratory of Nephropathology LR00SP01, Tunis, Tunisia"},{"name":"Faculty of Medicine of Tunisia, Tunis University El Manar, Tunis, Tunisia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ezzeddine","family":"Abderrahim","sequence":"additional","affiliation":[{"name":"Department of Medecine A, Charles Nicolle Hospital, Tunis, Tunisia"},{"name":"Faculty of Medicine of Tunisia, Tunis University El Manar, Tunis, Tunisia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2023,10,31]]},"reference":[{"key":"bibr1-11795476231210137","doi-asserted-by":"publisher","DOI":"10.1097\/MPH.0000000000000872"},{"key":"bibr2-11795476231210137","doi-asserted-by":"publisher","DOI":"10.1002\/art.40417"},{"key":"bibr3-11795476231210137","doi-asserted-by":"publisher","DOI":"10.1007\/s10067-015-2923-0"},{"key":"bibr4-11795476231210137","doi-asserted-by":"publisher","DOI":"10.1016\/j.coi.2017.08.004"},{"key":"bibr5-11795476231210137","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.21039"},{"key":"bibr6-11795476231210137","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1038\/kisup.2012.1","volume":"2","author":"Kidney Disease: Improving Global Outcomes (KDIGO) Acute Kidney Injury Work Group","year":"2012","journal-title":"Kidney Int"},{"key":"bibr7-11795476231210137","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2004070549"},{"key":"bibr8-11795476231210137","doi-asserted-by":"publisher","DOI":"10.1186\/s12969-016-0130-4"},{"key":"bibr9-11795476231210137","doi-asserted-by":"publisher","DOI":"10.1002\/art.38802"},{"key":"bibr10-11795476231210137","doi-asserted-by":"publisher","DOI":"10.1038\/nrrheum.2015.179"},{"key":"bibr11-11795476231210137","doi-asserted-by":"publisher","DOI":"10.1002\/art.39332"},{"key":"bibr12-11795476231210137","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2005.042143"},{"key":"bibr13-11795476231210137","doi-asserted-by":"crossref","first-page":"194","DOI":"10.1016\/j.jbspin.2011.10.015","volume":"79","author":"Larroche C.","year":"2012","journal-title":"Joint Bone Spine"},{"key":"bibr14-11795476231210137","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2019.00119"},{"key":"bibr15-11795476231210137","first-page":"322","volume":"2","author":"Jagtap S","year":"2013","journal-title":"J Bio Innov"},{"key":"bibr16-11795476231210137","first-page":"230","volume":"132","author":"Emmenegger U","year":"2002","journal-title":"Swiss Med Wkly"},{"key":"bibr17-11795476231210137","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2141.1996.d01-1707.x"},{"key":"bibr18-11795476231210137","doi-asserted-by":"publisher","DOI":"10.1007\/s002770000155"},{"key":"bibr19-11795476231210137","doi-asserted-by":"publisher","DOI":"10.1016\/S0248-8663(02)00673-2"},{"key":"bibr20-11795476231210137","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-114-5-387"},{"key":"bibr21-11795476231210137","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/key006"},{"key":"bibr22-11795476231210137","doi-asserted-by":"publisher","DOI":"10.1002\/art.24883"},{"key":"bibr23-11795476231210137","volume":"35","author":"Morales P","year":"1992","journal-title":"Arthritis Rheum"},{"key":"bibr24-11795476231210137","doi-asserted-by":"publisher","DOI":"10.1177\/0961203314529467"},{"key":"bibr25-11795476231210137","doi-asserted-by":"publisher","DOI":"10.1016\/j.patbio.2003.12.001"},{"key":"bibr26-11795476231210137","doi-asserted-by":"publisher","DOI":"10.1016\/j.annfar.2011.11.023"},{"key":"bibr27-11795476231210137","doi-asserted-by":"publisher","DOI":"10.1002\/art.41052"},{"key":"bibr28-11795476231210137","doi-asserted-by":"publisher","DOI":"10.1080\/07853890500465189"},{"key":"bibr29-11795476231210137","doi-asserted-by":"publisher","DOI":"10.1007\/s13224-011-0073-0"},{"key":"bibr30-11795476231210137","doi-asserted-by":"publisher","DOI":"10.1038\/nri3401"},{"key":"bibr31-11795476231210137","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-008-1111-y"},{"key":"bibr32-11795476231210137","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(07)70290-6"},{"key":"bibr33-11795476231210137","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.12386"},{"key":"bibr34-11795476231210137","doi-asserted-by":"publisher","DOI":"10.1016\/j.autrev.2017.05.010"},{"key":"bibr35-11795476231210137","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)61048-X"},{"key":"bibr36-11795476231210137","doi-asserted-by":"publisher","DOI":"10.1016\/j.autrev.2016.09.016"},{"key":"bibr37-11795476231210137","doi-asserted-by":"publisher","DOI":"10.1007\/s10067-013-2227-1"},{"key":"bibr38-11795476231210137","first-page":"1719","volume":"53","author":"Inoue N","year":"2014","journal-title":"Intern Med"}],"container-title":["Clinical Medicine Insights: Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/11795476231210137","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/11795476231210137","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/11795476231210137","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T09:14:24Z","timestamp":1777454064000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/11795476231210137"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,1]]},"references-count":38,"alternative-id":["10.1177\/11795476231210137"],"URL":"https:\/\/doi.org\/10.1177\/11795476231210137","relation":{},"ISSN":["1179-5476","1179-5476"],"issn-type":[{"value":"1179-5476","type":"print"},{"value":"1179-5476","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,1]]},"article-number":"11795476231210137"}}