Sudden Cardiac Arrest Due to Hemophagocytic Lymphohistiocytosis in a Child

Publication date: Available online 22 September 2018

Source: The Journal of Emergency Medicine

Author(s): Michael C. McCrory, Sophia S. Wang, Avinash K. Shetty, Thomas W. McLean, Patrick E. Lantz, Michael L. Cannon

Abstract

Background

Hemophagocytic lymphohistiocytosis (HLH) is an uncommon hyperinflammatory condition in children that may acutely mimic septic shock. Sudden out-of-hospital cardiac arrest in children is also uncommon and may be of unclear etiology upon initial presentation.

Case Report

A 10-year-old previously healthy child presented with sudden cardiac arrest after an insidious course of throat pain, fever, and progressive altered mental status. He was subsequently diagnosed with Epstein-Barr virus-associated HLH and suffered cerebral edema and death.

Why Should an Emergency Physician be Aware of This?

HLH has not previously been described as a cause of sudden out-of-hospital cardiac arrest in children. Rapid diagnosis of underlying cause of an unexpected cardiac arrest may help guide appropriate therapy to salvage organ function.

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