title: Haemophagocytic lymphohistiocytosis: a cause for rare but fatal outcome in tuberculosis.
abstract: Haemophagocytic lymphohistiocytosis (HLH), also called haemophagocytic syndrome (HPS) is characterised by a dysregulated activation and proliferation of macrophages, leading to uncontrolled phagocytosis of platelets, erythrocytes, lymphocytes and their haematopoietic precursors throughout the reticuloendothelial system. Mycobacterium tuberculosis-associated HPS is a rare and underdiagnosed association. We report a 34-year-old male patient diagnosed with tubercular pleural effusion responding poorly to antitubercular treatment. Patient later developed generalised lymphadenopathy, pancytopaenia and liver dysfunction and was eventually diagnosed as HLH. Despite being treated as per HLH protocol 2004 he could not be saved.
authors.affiliation: Department of Internal Medicine, PGIMER and Dr Ram Manohar Lohia Hospital, New Delhi, India. puneetaggarwal4u@gmail.com
authors.forename: Puneet
authors.initials: P
authors.lastname: Aggarwal
authors.forename: Gunjan
authors.initials: G
authors.lastname: Kumar
authors.forename: Nishanth
authors.initials: N
authors.lastname: Dev
authors.forename: Pushpa
authors.initials: P
authors.lastname: Kumari
mesh_terms: D000328:Adult; D017809:Fatal Outcome; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging / Q000473:pathology; D051359:Lymphohistiocytosis, Hemophagocytic / Q000150:complications* / Q000473:pathology; D008297:Male; D010306:Parotid Gland / Q000000981:diagnostic imaging / Q000473:pathology; D049268:Positron-Emission Tomography; D014057:Tomography, X-Ray Computed; D014397:Tuberculosis, Pulmonary / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology