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Year : 2022  |  Volume : 2  |  Issue : 3  |  Page : 99-102

Hemophagocytic lymphohistiocytosis secondary to classic hodgkin lymphoma in a patient with decompensated chronic liver disease

1 Department of Gastroenterology, Apollo Hospital, Chennai, Tamil Nadu, India
2 Department of Pathology, Apollo Hospital, Chennai, Tamil Nadu, India
3 Department of Haematology, Apollo Hospital, Chennai, Tamil Nadu, India

Correspondence Address:
Kartik Natarajan
Flat Number 6, Second Floor, Gopalkunj, Srinivasa Pillai Street, West Mambalam, Chennai - 600 033, Tamil Nadu
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ghep.ghep_33_21

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Hemophagocytic lymphohistiocytosis (HLH) is an aggressive and life-threatening syndrome of excessive immune activation. It is characterized by fever, cytopenias, splenomegaly, jaundice, neurological symptoms, and hemophagocytosis in bone marrow, liver, or lymph nodes. Secondary HLH is commonly associated with hematological malignancies, particularly non-Hodgkin lymphoma. We report a case of a patient with liver decompensation with spontaneous bacterial peritonitis and fever of unknown origin caused by malignant infiltration by classic Hodgkin lymphoma and secondary HLH. The patient was managed with modified dose of adriamycin, bleomycin, vinblastine, and dexamethasone and showed response post two cycles and is planned for two more cycles. The case highlights the importance of investigating persistent fever and accurately diagnosing and promptly treating HLH which can otherwise have a rapidly fatal course.

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