Drug-induced secondary haemophagocytic lymphohistiocytosis in hairy cell leukaemia

J R Coll Physicians Edinb. 2023 Dec 30:14782715231220108. doi: 10.1177/14782715231220108. Online ahead of print.ABSTRACTHaemophagocytic lymphohistiocytosis (HLH) is a rare, aggressive, excess immune activation syndrome. Diagnosis can be challenging due to its several clinical mimics including sepsis. There are multiple aetiologies of HLH; in adults, it is most commonly triggered by infection, malignancy, drugs and autoimmune processes. Failure to rapidly diagnose and treat this condition can be fatal. The management of HLH includes identifying and removing the trigger, supportive management and immunosuppression. Identifying the trigger is essential to inform the most appropriate type of immunosuppression. Here, we report a case of likely drug-induced HLH in a patient recently treated for hairy cell leukaemia. The culprit drug was thought to be co-trimoxazole and this case report highlights a very rare complication of this commonly used drug. We discuss our management approach with steroid monotherapy and withdrawal of co-trimoxazole.PMID:38160201 | DOI:10.1177/14782715231220108
Source: Journal of the Royal College of Physicians of Edinburgh - Category: General Medicine Authors: Source Type: research