Rare case of hemophagocytic lymphohistiocytosis: a case report

ABSTRACT

A two-month old infant was admitted to our hospital with history of fever and cough. He was active and playful with normal systemic examination. He was started on antibiotics because the C-reactive protein [CRP] was high. Over the next few days he deteriorated with persisting fever, altered sensorium and hepatomegaly. Inspite of using third line antibiotics, the CRP kept increasing and the child showed no signs of improvement. A possibility of Hemophagocytic Lymphohistiocytosis [HLH] was considered. Ferritin was high and so the child was referred to a tertiary centre for further treatment. Bone marrow biopsy confirmed the diagnosis of HLH. HLH is a clinical syndrome of hyper inflammation, and uncontrolled and ineffective immune response. It could be primary where genetic mutations have been demonstrated or secondary to infection, malignancy or metabolic condition. Criteria have been laid done for the diagnosis of HLH. This condition should be considered when there is continued deterioration in spite of maximal supportive care