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World J Crit Care Med. Sep 9, 2026; 15(3): 120840
Published online Sep 9, 2026. doi: 10.5492/wjccm.120840
Published online Sep 9, 2026. doi: 10.5492/wjccm.120840
Hemophagocytic lymphohistiocytosis in critically ill patients: A guide for clinicians
Wagner Nedel, Department of Intensive Care Unit, Conceição Hospital Group, Porto Alegre 91350200, Brazil
Author contributions: Nedel W contributed to conceptualization and manuscript writing.
Conflict-of-interest statement: The author reports no relevant conflicts of interest for this article.
Corresponding author: Wagner Nedel, MD, PhD, Assistant Professor, Department of Intensive Care Unit, Conceição Hospital Group, Francisco Trein 596, Segundo Andar, Porto Alegre 91350200, Brazil. wagnernedel@gmail.com
Received: March 10, 2026
Revised: April 12, 2026
Accepted: June 1, 2026
Published online: September 9, 2026
Processing time: 165 Days and 9.2 Hours
Revised: April 12, 2026
Accepted: June 1, 2026
Published online: September 9, 2026
Processing time: 165 Days and 9.2 Hours
Core Tip
Core Tip: Secondary hemophagocytic lymphohistiocytosis is a severe hyperinflammatory condition that frequently resembles or complicates sepsis in patients who are critically ill. A high level of clinical suspicion is necessary when patients present with ongoing fever, unexplained reductions in blood cell counts, and extremely high levels of ferritin. Employing the HScore or hemophagocytic lymphohistiocytosis-2004 criteria aids in making an earlier diagnosis. Swift, multidisciplinary management that emphasizes identifying triggers and applying customized immunosuppression is crucial to lowering the high mortality rates linked to multiorgan failure.