TNF and hemophagocytic syndrome: The cytokines measurement results showed that the levels of most of Th1 cytokines (TNF-α, IFN-γ, IL-1beta, IL-6, IL-8, IL-12p70), Th2 cytokines (IL-4) and Th17 cytokine (IL-17, IL-23) were significantly higher in VL associated HLH group than those with VL only except for the regulatory cytokine IL-10 which was higher in VL group than in VL associated HLH group (Fig 2).