DOI: https://doi.org/10.36347/sjmcr.2025.v13i01.018

Pages: 87-91

Hemophagocytic lymphohistiocytosis (HLH) is an uncommon systemic inflammatory syndrome that can happen secondary to numerous conditions. It rarely occurs due to dengue infection causing significant mortality and morbidity even with appropriate treatment. In both case- 1 & 2, HLH was suspected due to high grade fever, bicytopenia and worsening of liver function along with raised serum ferritin level. Both patients described in this case report underwent bonemarrow biopsy which showed presence of hemophagocytic activity. Both patients were started on intravenous methylprednisolone and responded well withresolution of clinical symptoms and blood parameter. Therefore, early recognition and diagnosis of dengue associated with HLH and prompt treatment have favourable outcome in these patients. After diagnosing HLH, our patient were started with intravenous methylprednisolone for 3 days and followed by oral prednisolone with gradually tapered over 6 weeks. Both patients had an excellent response to treatment solely with intravenous methylprednisolone. The outcome is further poor if the diagnosis of HLH is delayed or left untreated. These report highlights the importance of early recognition of this condition as prompt appropriate treatment improves outcomes.