A rare case of hemophagocytic lymphohistiocytosis triggered by disseminated tuberculosis

Hemophagocytic lymphohistiocytosis (HLH) is an uncommon, life threatening hyperinflammatory syndrome caused by severe hypercytokinemia due to highly stimulated but ineffective immune process, leading to phagocytosis of erythrocytes, leukocytes, platelets and their precursors in bone marrow and other tissues by macrophages. There are two types, which are primary HLH and secondary HLH. HLH is a potentially treatable condition which is often missed due to lack of suspicion, variable and nonspecific presentations and inability to fulfill all the diagnostic criteria. Prompt initiation of immunochemotherapy is essential but timely diagnosis may be challenging, because of rarity of HLH. We report a case of secondary HLH in 62-year-old female, triggered by disseminated tuberculosis.