Evidence map›Paper›PMID 39581974›Full record

SynthesisBMC infectious diseases2024

Comprehensive insights into tuberculosis-associated hemophagocytic lymphohistiocytosis: a systematic review.

Arvin Eslami, Shaya Alimoghadam, Sanaz Khodadadi, Hadi Allahverdi, Rojina Alimoghadam, Amir Kasaeian, Davood Mansouri, Kamran Alimoghaddam, Ilad Alavi Darazam

Abstract readSystematic Review
In one paragraph

Synthesis in BMC infectious diseases, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Arvin Eslami *Infectious Diseases and Tropical Medicine Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Shaya Alimoghadam *Infectious Diseases and Tropical Medicine Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Sanaz KhodadadiInfectious Diseases and Tropical Medicine Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Hadi AllahverdiInfectious Diseases and Tropical Medicine Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Rojina AlimoghadamInfectious Diseases and Tropical Medicine Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Amir KasaeianDigestive Oncology Research Center, Digestive Diseases Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Davood MansouriInfectious Diseases and Tropical Medicine Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Kamran AlimoghaddamHematology, Oncology and Stem Cell Transplantation Research Center, Research Institute for Oncology, Hematology and Cell Therapy, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. Alimgh@tums.ac.ir.
Ilad Alavi DarazamInfectious Diseases and Tropical Medicine Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. ilad13@yahoo.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTuberculosis-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.

methodsWe 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.

resultsA 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).

conclusionIntegrating ATT with HLH-specific therapies significantly enhances survival in TB-HLH patients. Additionally, IVIG plays a key role in improving outcomes. Age ≥ 44 years and comorbidities are critical risk factors for increased mortality. Early and high suspicion of TB-HLH is essential, especially in high TB burden regions or recent travel contexts. Future research should focus on prospective multicenter studies to validate our findings and develop standardized treatment strategies on TB-HLH. PROSPERO: CRD42022364180.

Indexed as

Lymphohistiocytosis, HemophagocyticTuberculosisAdultAntitubercular AgentsFemaleHumansMaleMiddle AgedRisk FactorsTreatment OutcomeAntitubercular AgentsHemophagocytic lymphohistiocytosisHLHIntravenous immunoglobulinTB-HLHTuberculosis

Identifiers

PMID39581974
PMCPMC11587777

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.