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Summary
Haemophagocytic lymphohistiocytosis (HLH) is a rare and potentially fatal disorder. It is challenging to diagnose due to its rarity and variation in clinical presentation, laboratory abnormalities and underlying aetiologies. A reproductive-aged woman, gravida 2 para 1001 at 27 weeks gestation presented with fever, hypotension and subacute upper respiratory infection. She delivered a male infant by caesarean section secondary to fetal distress. Subsequently, she was diagnosed with T-cell lymphoma and secondary HLH. Despite management with supportive care and multiple chemotherapeutic agents, she ultimately died of multiorgan failure. Patients with HLH secondary to malignancy have a particularly poor prognosis. This case highlights the importance of considering secondary HLH in the differential diagnosis of a patient with fever, pancytopenia and systemic symptoms of unclear aetiology in pregnancy.
- obstetrics, gynaecology and fertility
- haematology (incl blood transfusion)
- Immunology
- adult intensive care
- pregnancy
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Footnotes
Contributors Each of the authors contributed a significant amount in the production of this manuscript:. BN: performed initial literature search, drafted the original manuscript and formatted the paper according to the journal specifications. AC: contacted the next of kin to obtain consent, planned the outline of the paper, performed additional literature search and performed major edits to the manuscript. MZ: senior author; performed major edits to the manuscript, helped with initial concept and design and suggested important revisions.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Patient consent Next of kin consent obtained.
Provenance and peer review Not commissioned; externally peer reviewed.