Open AccessHemophagocytic lymphohistiocytosis--late diagnosis in an adult patient
Author(s) -
Dawn V Y Ng,
Nina Ghosh,
Lisa K. Hicks
Publication year - 2009
Publication title -
bmj case reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.231
H-Index - 26
ISSN - 1757-790X
DOI - 10.1136/bcr.05.2009.1858
Subject(s) - medicine , hemophagocytic lymphohistiocytosis , presentation (obstetrics) , intensive care unit , pediatrics , intensive care medicine , sepsis , case presentation , disease , surgery
We present a case of hemophagocytic lymphohistiocytosis (HLH) in a previously healthy 30-year-old woman. The patient presented with features consistent with HLH: persistent fever, neurological abnormalities, lymphadenopathy, anaemia, leucopoenia and markedly elevated serum lactate dehydrogenase and ferritin levels. Diagnosis was delayed for approximately 1 month beyond presentation. Once initiated on treatment, the patient rapidly improved and was discharged from the intensive care unit and subsequently sent home. Unfortunately, she succumbed to progressive HLH 5 months after her initial presentation. This case highlights key clinical features associated with HLH to help prevent late diagnosis as delayed treatment may lead to irreversible multi-organ failure and/or death.