Journal of Clinical Immunology

, Volume 39, Issue 2, pp 135–137 | Cite as

IFN-g:IL-10 Ratio: a Putative Predictive Biomarker to Discriminate HLH From Severe Viral Infections

  • Snehal Shabrish
  • Mukesh Desai
  • Vinay Saxena
  • Madhura Kelkar
  • Manisha MadkaikarEmail author
Letter to Editor

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 [1] 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...


Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Pediatric Immunology and Leukocyte BiologyNational Institute of Immunohaematology (ICMR)MumbaiIndia
  2. 2.Division of ImmunologyBai Jerbai Wadia Hospital for ChildrenMumbaiIndia
  3. 3.National Institute of VirologyMumbaiIndia

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