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Secondary hemophagocytic lymphohistiocytosis in the setting of metastatic renal cell carcinoma: a case report

Overview of attention for article published in Journal of Medical Case Reports, March 2017
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  • Above-average Attention Score compared to outputs of the same age and source (57th percentile)

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1 tweeter
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1 Facebook page

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22 Mendeley
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Title
Secondary hemophagocytic lymphohistiocytosis in the setting of metastatic renal cell carcinoma: a case report
Published in
Journal of Medical Case Reports, March 2017
DOI 10.1186/s13256-016-1196-9
Pubmed ID
Authors

Monica El-Masry, Lauren Eisenbud, Minh-Ha Tran

Abstract

Hemophagocytic lymphohistiocytosis is a disease process characterized by unregulated hyperactivation of the immune system associated with multiorgan involvement and high mortality rates. Early recognition is crucial and a recently validated diagnostic schema, the H-Score, may facilitate diagnosis particularly in secondary hemophagocytic lymphohistiocytosis cases. We present a patient with secondary hemophagocytic lymphohistiocytosis in association with metastatic renal cell carcinoma in whom high-dose steroid therapy induced a remarkable response. A 35-year-old Vietnamese man with quiescent systemic lupus erythematosus was diagnosed 5 months prior to admission with left-sided renal cell carcinoma metastatic to the pancreas and spine. Ten days prior to admission, a febrile illness (temperatures to 39 °C) associated with flu-like symptoms unresponsive to levofloxacin developed. He took only two doses of pazopanib prior to admission. High fevers unresponsive to antimicrobial therapy, cytopenias, disseminated intravascular coagulation, and progressive multiorgan failure led to intubation and intensive care unit stay. Extensive infectious disease workup showed only negative results, but elevation of interleukin-2 receptor, exceedingly high ferritin levels and other features earned an H-Score of 302, consistent with >99% diagnostic probability for secondary hemophagocytic lymphohistiocytosis. High-dose steroid therapy produced a rapid clinical and biochemical response. Hemophagocytic lymphohistiocytosis is a life-threatening disorder which is likely to be under-recognized. Increased awareness of this disease entity and its diagnosis is crucial toward early recognition and treatment. To our knowledge, our patient is only the second reported with secondary hemophagocytic lymphohistiocytosis occurring in the setting of renal cell carcinoma.

Twitter Demographics

The data shown below were collected from the profile of 1 tweeter who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 22 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 22 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 3 14%
Researcher 3 14%
Student > Postgraduate 2 9%
Student > Doctoral Student 2 9%
Unspecified 2 9%
Other 6 27%
Unknown 4 18%
Readers by discipline Count As %
Medicine and Dentistry 12 55%
Unspecified 2 9%
Nursing and Health Professions 1 5%
Pharmacology, Toxicology and Pharmaceutical Science 1 5%
Decision Sciences 1 5%
Other 2 9%
Unknown 3 14%

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 06 March 2017.
All research outputs
#8,722,662
of 11,330,364 outputs
Outputs from Journal of Medical Case Reports
#835
of 1,684 outputs
Outputs of similar age
#173,518
of 257,704 outputs
Outputs of similar age from Journal of Medical Case Reports
#36
of 99 outputs
Altmetric has tracked 11,330,364 research outputs across all sources so far. This one is in the 19th percentile – i.e., 19% of other outputs scored the same or lower than it.
So far Altmetric has tracked 1,684 research outputs from this source. They receive a mean Attention Score of 3.4. This one is in the 44th percentile – i.e., 44% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 257,704 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 26th percentile – i.e., 26% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 99 others from the same source and published within six weeks on either side of this one. This one has gotten more attention than average, scoring higher than 57% of its contemporaries.