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Case Reports: Adverse drug reactions and complications
Lamotrigine-associated haemophagocytic lymphohistiocytosis (HLH) confounded with underlying rheumatoid arthritis
  1. Dhivya Velu1,
  2. Leela Kantamneni1,
  3. Syeda Sabeeka Batool1 and
  4. Ali Hachem2
  1. 1Internal Medicine, UAB Huntsville Regional Medical Campus, Huntsville, Alabama, USA
  2. 2Department of Hemato-Oncology, The Cancer Center, Huntsville Hospital, Alabama, USA
  1. Correspondence to Dr Dhivya Velu; drdhivyavelu{at}gmail.com

Abstract

Haemophagocytic lymphohistiocytosis (HLH) is one of the rare haematological syndromes more commonly reported in infants/children than adults. This disease is known for its aggressive dysregulated immune response affecting the host rapidly, causing multiorgan dysfunction and thus carries a high mortality. The disease still remains cryptic in this current decade despite all the developments in the ever-evolving field of haematology. Due to its rare occurrence and being more frequent in infants and the paediatric population, the literature lacks enough data to standardise therapies. Such events in adults and the elderly are invariably related to an underlying insult such as infections, other autoimmune or rheumatological diseases or drugs. We describe an interesting case of a middle-aged Caucasian woman who presented with fever, pancytopenia and hepatitis, who was eventually diagnosed with HLH just in time to receive the life-saving specific treatment as per available guidelines.

  • drugs and medicines
  • haematology (drugs and medicines)
  • medical management

https://doi.org/10.1136/bcr-2021-245835

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    Footnotes

    • Contributors DV was involved in the collection of the data and primary drafting. LK and SSB were involved in editing and supplemental data collection. AH was involved in mentoring, confirming the details and proofreading.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.