A previously healthy 21-year-old woman was admitted for a month with fever, malaise and liver test abnormalities.
Upon admission, he was found to have fallen and without alterations in the physical examination.
Laboratory tests showed pancithemoglobin 300 gr%, leukocytes 1,900/uL, platelets 43,000/mL) and liver test abnormalities (GOT 1,800 U/L, GPT).
Infectious diseases were negative (servocultive, urocultive, hepatotropic virus, mycoplasma, toxoplasma, leptospira, bartonella, brucampella, HIV19).
A retrospective study was conducted where ANA was 1:40 mottled pattern and anti DNA by FARR, rheumatoid factor and ENA profile negative with normal complement.
The patient continued with fever and worsening liver tests.
A CT scan of the chest, abdomen and abdomen showed diffuse lymph nodes, bilateral pleural effusion, and hepatosplenic enlargement.
A lymph node biopsy showed nonspecific adenitis.
Ferritin levels were 23,460 U/L. A bone marrow study showed lymphoid hyperplasia and abundant hemophagocytes.
The patient started treatment with HLH 04 protocol with good clinical response, with normalization of liver tests and decrease in ferritin to normal values.
At the time of writing this report, the patient has been treated for 24 months without complications and with good quality of life.
The patient has no HLA-compatible siblings.
