Sudden Cardiac Arrest Due to Hemophagocytic Lymphohistiocytosis in a Child

J Emerg Med. 2018 Nov;55(5):e119-e123. doi: 10.1016/j.jemermed.2018.08.007. Epub 2018 Sep 22.


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.

Keywords: child; hemophagocytic lymphohistiocytosis; multiple organ failure; sudden cardiac death.

Publication types

  • Case Reports

MeSH terms

  • Child
  • Death, Sudden, Cardiac / etiology*
  • Fatal Outcome
  • Humans
  • Lymphohistiocytosis, Hemophagocytic / complications*
  • Male