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Unauthorized reproduction of this article is prohibited Pediatric Critical Care Medicine 2018 • Volume 19 • Number 6 (Suppl.) when fever continues more than 7 days with raising transaminases and cytopenia. The mean duration of diagnosis of HLH was 8 days. All children (n=12) had splenomegaly, edema, ascites, pancytopenia, elevated liver enzymes, raised ferritin (>500ug/L), high lactate dehydrogenase and bone marrow evidence of haemophagocytic activity. Lymphadenopathy was observed in 83.3% (n=10). Central nervous system involvement was seen in 25% (n=3). Hypertriglyceridemia (>265mg/dl) and Hypofibrogenemia (< 150mg/dL) observed in 5 and 8 patients respectively. Eleven children who survived until the commencement of treatment received dexamethasone for a period of one month. Ten children showed clinical recovery within 48 hours of therapy and one child died due to secondary infection. Biochemical changes took few week to improve.