Hemophagocytic Lymphohistiocytosis (HLH)

HLH is a reactive process resulting from prolonged and excessive antigen-presenting cell activation [1]. Hemophagocytosis is a hallmark of activated macrophages/histiocytes. The predominant clinical findings of HLH are fever (often hectic and persistent), cytopenia, hepatitis, and splenomegaly. A case of HLH in a 32-year-old female with no past medical history was presented in the current paper. She was admitted to the medical department with a fever and thrombocytopenia for evaluation. After failure to respond to a brief course of empiric antibiotics, the patient was extensively investigated and finally diagnosed with HLH (bone marrow aspiration showed occasional hemophagocytes). She was started on steroids but, failed to respond and so immunosuppressant drugs were added to the therapy.