IFN-g:IL-10 Ratio: a Putative Predictive Biomarker to Discriminate HLH From Severe Viral Infections
To the Editor,
Hemophagocytic lymphohistiocytosis (HLH) is a life-threatening, hyperinflammatory syndrome, caused due to immune dysregulation. HLH may occur as a primary (genetic) condition due to mutations in genes important in the pathway of granule-mediated cytotoxicity or as a secondary condition where identical clinical findings may arise secondary to infectious, rheumatologic, malignant, or metabolic conditions. Preliminary diagnosis of HLH is based on guidelines of the Histiocyte Society  which includes clinical manifestations and laboratory investigations. These criteria are useful for HLH diagnosis especially when the definitive genetic diagnosis is absent. However, several diagnostic challenges still prevail; one of which is differentiating severe infection from HLH precipitated by infection. Viral infections are frequently implicated at the onset of active HLH episodes. Viral infections are also known to have an impact on NK cell and cytotoxic T cell (CTL) function and...
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Conflict of Interest
The authors declare that they have no conflict of interest.
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