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May 20, 2026American Journal of Respiratory and Critical Care Medicine

C50-22 When Sepsis Isn’t Sepsis: A Case of Fatal Secondary Hemophagocytic Lymphohistiocytosis

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Authors

TIT IslamJKJ KaurFSF Sajid

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Overview

Case presentation shows HLH mimics severe sepsis, highlighting the need for early diagnosis and treatment.

Key Points

  • The case aims to illustrate the complexities of diagnosing hemophagocytic lymphohistiocytosis (HLH), often confused with severe sepsis.
  • Case presentation of a 55-year-old man with severe symptoms and laboratory findings suggestive of HLH.
  • Performing a bone marrow biopsy and diagnostic tests including flow cytometry and cytogenetics.
  • Initiating high-dose corticosteroids and etoposide treatment despite deteriorating condition.
  • Elevated ferritin levels at 11,878 ng/mL and increased soluble IL-2 receptor levels confirmed HLH.
  • Postmortem findings included diffuse hemophagocytosis and multiorgan involvement supporting HLH diagnosis.
  • Despite aggressive treatment, the patient developed refractory shock and had a fatal outcome.

Cite This Study

Islam et al. (2026) studied this question.

synapsesocial.com/papers/6a0d5013f03e14405aa9baa6https://doi.org/10.1093/ajrccm/aamag162.6214
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