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Hematology

Internal Medicine, East Africa

Hemophagocytic lymphohistiocytosis

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Adult Secondary Hemophagocytic Lymphohistiocytosis, Antonina Obayo, Karishma Sharma, Caroline Mithi, Riyat Malkit, Anne Mwirigi Oct 2020

Adult Secondary Hemophagocytic Lymphohistiocytosis, Antonina Obayo, Karishma Sharma, Caroline Mithi, Riyat Malkit, Anne Mwirigi

Internal Medicine, East Africa

Background: Hemophagocytic lymphohistiocytosis (HLH) is a syndrome of excessive inflammation and tissue destruction due to abnormal immune activation. HLH carries a very high mortality, and while delays in patients’ presentation to hospital, time to suspicion of HLH, investigation, and initiation of therapy all play a part, mortality remains high even with timely diagnosis and treatment. Classical manifestations of HLH include persistent fever, cytopenias, and liver dysfunction.

Case presentation: We present four cases of secondary HLH, highlighting the demographic and clinical characteristics of these patients, underlying triggers (including systemic lupus erythematosus, lymphoproliferative disorders, and leishmaniasis), together with challenges associated with the …