A Case of Secondary Hemophagocytic Lymphohistiocytosis in a Patient With Acute HIV Infection
A 22-year-old man who has sex with men with no significant medical history presented with a 2-week history of fever and right upper abdominal pain. Initial blood tests revealed leukopenia, thrombocytopenia, and elevated liver enzymes. The diagnosis of secondary hemophagocytic lymphohistiocytosis (HL...
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| Format: | Article |
| Language: | English |
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American College of Physicians
2025-06-01
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| Series: | Annals of Internal Medicine: Clinical Cases |
| Online Access: | https://www.acpjournals.org/doi/10.7326/aimcc.2025.0034 |
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| _version_ | 1850218370900688896 |
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| author | Yiliam Castillo Liorge Dominguez Antonio Crespo Julio J. Alvarez Cardona |
| author_facet | Yiliam Castillo Liorge Dominguez Antonio Crespo Julio J. Alvarez Cardona |
| author_sort | Yiliam Castillo |
| collection | DOAJ |
| description | A 22-year-old man who has sex with men with no significant medical history presented with a 2-week history of fever and right upper abdominal pain. Initial blood tests revealed leukopenia, thrombocytopenia, and elevated liver enzymes. The diagnosis of secondary hemophagocytic lymphohistiocytosis (HLH) was supported by fever, splenomegaly, hypertriglyceridemia, hyperferritinemia, and high soluble interleukin-2 receptors, meeting the 5/8 criteria of the Histiocyte Society-2004. Further laboratory tests indicated an elevated HIV RNA viral load, supporting a diagnosis of acute HIV infection. Our case suggests that identifying acute HIV infection as a trigger for secondary HLH is crucial for enabling prompt initiation of therapy, potentially preventing fatal outcomes. |
| format | Article |
| id | doaj-art-9f9137523d8d43158e2dd0b0fe2b1398 |
| institution | OA Journals |
| issn | 2767-7664 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | American College of Physicians |
| record_format | Article |
| series | Annals of Internal Medicine: Clinical Cases |
| spelling | doaj-art-9f9137523d8d43158e2dd0b0fe2b13982025-08-20T02:07:46ZengAmerican College of PhysiciansAnnals of Internal Medicine: Clinical Cases2767-76642025-06-014610.7326/aimcc.2025.0034A Case of Secondary Hemophagocytic Lymphohistiocytosis in a Patient With Acute HIV InfectionYiliam Castillo0Liorge Dominguez1Antonio Crespo2Julio J. Alvarez Cardona31Department of Infectious Disease, Orlando Regional Medical Center, Orlando, Florida1Department of Infectious Disease, Orlando Regional Medical Center, Orlando, Florida1Department of Infectious Disease, Orlando Regional Medical Center, Orlando, Florida1Department of Infectious Disease, Orlando Regional Medical Center, Orlando, FloridaA 22-year-old man who has sex with men with no significant medical history presented with a 2-week history of fever and right upper abdominal pain. Initial blood tests revealed leukopenia, thrombocytopenia, and elevated liver enzymes. The diagnosis of secondary hemophagocytic lymphohistiocytosis (HLH) was supported by fever, splenomegaly, hypertriglyceridemia, hyperferritinemia, and high soluble interleukin-2 receptors, meeting the 5/8 criteria of the Histiocyte Society-2004. Further laboratory tests indicated an elevated HIV RNA viral load, supporting a diagnosis of acute HIV infection. Our case suggests that identifying acute HIV infection as a trigger for secondary HLH is crucial for enabling prompt initiation of therapy, potentially preventing fatal outcomes.https://www.acpjournals.org/doi/10.7326/aimcc.2025.0034 |
| spellingShingle | Yiliam Castillo Liorge Dominguez Antonio Crespo Julio J. Alvarez Cardona A Case of Secondary Hemophagocytic Lymphohistiocytosis in a Patient With Acute HIV Infection Annals of Internal Medicine: Clinical Cases |
| title | A Case of Secondary Hemophagocytic Lymphohistiocytosis in a Patient With Acute HIV Infection |
| title_full | A Case of Secondary Hemophagocytic Lymphohistiocytosis in a Patient With Acute HIV Infection |
| title_fullStr | A Case of Secondary Hemophagocytic Lymphohistiocytosis in a Patient With Acute HIV Infection |
| title_full_unstemmed | A Case of Secondary Hemophagocytic Lymphohistiocytosis in a Patient With Acute HIV Infection |
| title_short | A Case of Secondary Hemophagocytic Lymphohistiocytosis in a Patient With Acute HIV Infection |
| title_sort | case of secondary hemophagocytic lymphohistiocytosis in a patient with acute hiv infection |
| url | https://www.acpjournals.org/doi/10.7326/aimcc.2025.0034 |
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