Hemophagocytic lymphohistiocytosis in pregnancy—a case report

Abstract

Hemophagocytic lymphohistiocytosis (HLH) is a life-threatening condition that is a rare occurrence in pregnancy and can be elusive in its diagnosis thereby delaying treatment. We report the case of a 30-year-old female patient at 36 weeks of pregnancy who presented with a persistent fever that did not respond to antibiotics. After we investigated her thoroughly, considering the persistent fever, we performed a bone marrow biopsy as part of the workup for prolonged pyrexia. We diagnosed her with HLH secondary to cytomegalovirus pneumonia. As her laboratory investigations fulfilled the criteria for HLH we treated her with the appropriate therapy using a multidisciplinary approach, resulting in her complete recovery. HLH should be considered a potential differential diagnosis in pregnant patients complaining of persistent fever, cytopenia, or declining clinical condition despite delivery of the baby.