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Lamotrigine-associated hemophagocytic lymphohistiocytosis
  1. Nawar Suleman1,
  2. Metin Ozdemirli2 and
  3. David Weisman1
  1. 1Internal Medicine, MedStar Union Memorial Hospital, Baltimore, MD, USA
  2. 2Department of Pathology, Georgetown University School of Medicine, Washington, DC, USA
  1. Correspondence to Dr David Weisman; david.s.weisman{at}


Hemophagocytic lymphohistiocytosis (HLH) is a rare and life-threatening disorder of excessive immune activation. It is mostly seen in the paediatric population and is rarely observed in adults. HLH can be inherited or acquired and is commonly triggered by activation of the immune system by an underlying viral infection or in immune system deficiency such as malignancy or underlying rheumatological disease. HLH is a difficult entity to diagnose due to the rarity of this disorder, variable clinical presentation and non-specific clinical and laboratory findings. HLH carries a high mortality if left untreated, and therefore prompt diagnosis and initiation of immunosuppressive, immunomodulatory and cytostatic medications are critical to improve survival in affected patients. Here, we present a case of lamotrigine-associated HLH. To our knowledge, only eight other cases of lamotrigine-associated HLH have been reported in adult patients.

  • pharmacology and therapeutics
  • immunology

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  • Contributors NS, MO and DW were involved in the conception of the report, critical review of the manuscript and approval of the final manuscript. NS wrote the manuscript and was involved in the care of the patient.

  • 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 for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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