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Coagulopathy is an under-recognised complication of acquired HLH
  1. Serena Kosciejew1,
  2. Edward Morris1,2 and
  3. Joel Wight1,2
  1. 1Haematology and Bone Marrow Transplant, Townsville Hospital and Health Service, Townsville, Queensland, Australia
  2. 2College of Medicine and Dentistry, James Cook University, Townsville, Queensland, Australia
  1. Correspondence to Dr Serena Kosciejew; s.kosciejew{at}


Acquired haemophagocytic lymphohistiocytosis (aHLH) is a rare and often fatal process of uncontrolled cytokine release driven by the inability of natural killer cells to eliminate infected or malignant cells. Herein, we report two cases of aHLH complicated by bleeding secondary to coagulopathy due to hypofibrinogenaemia and thrombocytopenia despite appropriate correction with blood products. These cases highlight the effect coagulopathy and thrombocytopenia can have on patient outcomes when trying to confirm and manage the underlying process driving aHLH.

  • Haematology (incl blood transfusion)
  • Malignant and Benign haematology

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  • Contributors SK and JW conceptualised the project. SK, EM and JW undertook data extraction and interpretation. SK drafted the manuscript with all coauthors providing input, review and edits. Authors had full access to the data in the study and take responsibility for the integrity of the data and accuracy of the report.

  • 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.