A Hidden Cause of MERS and HLH in a Girl: Unusual Presentation of Hantaviruses Infection

Case report: Hemorrhagic fever with renal syndrome presenting as hemophagocytic lymphohistiocytosis

“…Rarely, HLH is associated with hemorrhagic fever with renal syndrome (HFRS) caused by Hantaan, Seoul, Dobrava/Belgrade, or Puumala virus. Six case reports have been described with only one identifying Puumala virus as the causal pathogen (2)(3)(4)(5)(6)(7). Here, we describe a case of HLH secondary to HFRS caused by Puumala virus.…”

“…Viral infections, such as Epstein-Barr virus, cytomegalovirus, influenza, SARS-CoV-2, and HIV, are known to trigger HLH(8,9). Rarely, HLH is associated with hemorrhagic fever with renal syndrome (HFRS)(2)(3)(4)(5)(6)(7).HFRS is a zoonotic viral disease caused by Old World hantaviruses, occurring in Asia and Europe, such as Hantaan, Seoul, Dobrava/Belgrade or Puumala virus. In contrast, New…”

Hemorrhagic fever with renal syndrome presenting as leukemoid reaction and hemophagocytic lymphohistiocytosis

“…So far, there are only five cases of HFRS presenting with secondary HLH. [6][7][8][9][10] Interestingly, cytopenia, characterized by decreased two or three cell lines, is very common in HLH. However, in our case, the patient manifested as LR, thus it is unique for this case.…”