Comprehensive insights into tuberculosis-associated hemophagocytic lymphohistiocytosis: a systematic review
Abstract
BACKGROUND: Tuberculosis-associated hemophagocytic lymphohistiocytosis (TB-HLH) presents significant challenges in diagnosis and treatment due to its complex interplay between TB and HLH. This systematic review aims to provide comprehensive insights into the epidemiology, clinical characteristics, and treatment outcomes of TB-HLH patients. METHODS: We performed a systematic review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, searching PubMed, Scopus, Web of Science, and Embase up to May 16, 2023, without language restrictions. We included case reports and cases series on patients with both TB and HLH with documented treatment outcomes. Data were analyzed using descriptive statistics, chi-square or Fisher's exact tests, t-tests, and mortality rates. Significant variables (p < 0.05) from univariate analysis and clinically relevant factors were used in binary logistic regression to determine odds ratios, 95% confidence intervals, and p-values. RESULTS: A total of 185 articles involving 213 patients were included. The overall mortality rate was 39%. Age ≥ 44 years and comorbidities were identified as independent risk factors for increased mortality (p = 0.005). Anti-tuberculosis treatment (ATT) combined with HLH-specific therapies, was associated with reduced mortality compared to ATT alone (p < 0.05), especially IVIG (p = 0.04). CONCLUSION: Integrating ATT with HLH-specific therapies significantly enhances survival in TB-HLH…
How strong is the evidence?
Evidence Hub reads this as a systematic review, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 213 participants or records.
Read the paper
Related studies
- Association of lower urinary tract symptoms and OAB severity with quality of life and mental health in China, Taiwan and South Korea: results from a cross-sectional, population-based study
- Ten-Day Quadruple Therapy Comprising Low-Dose Rabeprazole, Bismuth, Amoxicillin, and Tetracycline Is an Effective and Safe First-Line Treatment for Helicobacter pylori Infection in a Population with High Antibiotic Resistance: a Prospective, Multicenter, Randomized, Parallel-Controlled Clinical Trial in China
- The Role of the NLR and PLR in Urinary Tract Infection
- Threat of Antimicrobial Resistance among Pilgrims with Infectious Diseases during Hajj: Lessons Learnt from COVID-19 Pandemic
- Leclercia adecarboxylata urinary tract infection in a patient with bladder cancer and recurrent hematuria
- A Case Series of Staphylococcus lugdunensis Infection in Cancer Patients at an Academic Cancer Institute in the United States
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.