biostudies-literatureUnknown9De Smet MAJHemophagocytic lymphohistiocytosis may occur in patients with genetic predisposition and in sporadic cases due to malignancy or infection. We describe a 49-year old man with hemorrhagic fever, type 1 respiratory insufficiency and acute kidney injury. Diagnostic work up showed a hyperinflammatory syndrome, hypertriglyceridemia, hemophagocytosis, very high ferritin and significantly elevated sCD25. The findings were compatible with hemophagocytic lymphohistiocytosis based on the HLH-2004 criteria. Serological testing indentified <i>Puumala virus</i> as the causal pathogen. The patient was successfully treated with pulse corticosteroids, intravenous immunoglobins and supportive therapy.Frontiers in medicine1096900https://www.ebi.ac.uk/biostudies/studies/S-EPMC9790895biostudies-literatureCase report: Hemorrhagic fever with renal syndrome presenting as hemophagocytic lymphohistiocytosis.PMC9790895Bogaert SSchauwvlieghe ADe Smet MAJDendooven ADruwe PDepuydt PfalseCase report: Hemorrhagic fever with renal syndrome presenting as hemophagocytic lymphohistiocytosis.Hemophagocytic lymphohistiocytosis may occur in patients with genetic predisposition and in sporadic cases due to malignancy or infection. We describe a 49-year old man with hemorrhagic fever, type 1 respiratory insufficiency and acute kidney injury. Diagnostic work up showed a hyperinflammatory syndrome, hypertriglyceridemia, hemophagocytosis, very high ferritin and significantly elevated sCD25. The findings were compatible with hemophagocytic lymphohistiocytosis based on the HLH-2004 criteria. Serological testing indentified <i>Puumala virus</i> as the causal pathogen. The patient was successfully treated with pulse corticosteroids, intravenous immunoglobins and supportive therapy.2022-01-01T00:00:00Z20222025-04-18T13:09:52.591Z2025-02-19T04:42:56.308ZS-EPMC97908953657915410.3389/fmed.2022.1096900