Haemophagocytic lymphohistiocytosis (HLH) is an aggressive and life-threatening disease of disproportionate immune activation. We present a case of a 25-year-old woman who is postnatal day 26 status post lower segment caesarean section who came with fever, breathlessness and abdominal pain in shock in the background of a malarial infection 3 days ago, which was initially evaluated on the lines of fever with multiple organ dysfunction syndrome. On further evaluation turned out to fulfil the criteria for secondary HLH seemingly triggered by an infectious cause or an autoimmune phenomenon. On further assessment, she was found to be positive for antiphospholipid antibodies which forced other possible diagnoses such as catastrophic antiphospholipid antibody syndrome into contention.
- radiology (diagnostics)
- immunological products and vaccines
- gynaecology and fertility
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RBR and AD are joint first authors.
Contributors RR: conception, design of the study, acquisition of the data, drafting the manuscript, final approval of the version to be submitted. AD: acquisition of the data, revising the manuscript, final approval of the version to be submitted. AKV and CB: acquisition of the data, final approval of the version to be submitted.
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.
Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.