title: Hemophagocytic lymphohistiocytosis-late diagnosis in an adult patient.
abstract: We present a case of hemophagocytic lymphohistiocytosis (HLH) in a previously healthy 30-year-old woman. The patient presented with features consistent with HLH: persistent fever, neurological abnormalities, lymphadenopathy, anaemia, leucopoenia and markedly elevated serum lactate dehydrogenase and ferritin levels. Diagnosis was delayed for approximately 1 month beyond presentation. Once initiated on treatment, the patient rapidly improved and was discharged from the intensive care unit and subsequently sent home. Unfortunately, she succumbed to progressive HLH 5 months after her initial presentation. This case highlights key clinical features associated with HLH to help prevent late diagnosis as delayed treatment may lead to irreversible multi-organ failure and/or death.
authors.affiliation: University of Toronto, Medicine, 2nd floor, 500 University Ave, Toronto, Ontario, M5G 1V7, Canada.
authors.forename: Dawn
authors.initials: D
authors.lastname: Ng
authors.forename: Nina
authors.initials: N
authors.lastname: Ghosh
authors.forename: Lisa K
authors.initials: LK
authors.lastname: Hicks