# Early Diagnosis of Hemophagocytic Lymphohistiocytosis in an Adult Presenting With Sickle Cell Disease: A Case Report

## TL;DR

This case report highlights the early diagnosis of a rare immune disorder in an adult with sickle cell disease, emphasizing the importance of timely treatment.

## Contribution

The novelty lies in identifying hemophagocytic lymphohistiocytosis in a patient with sickle cell disease through early diagnosis and effective treatment.

## Key findings

- A 33-year-old male with sickle cell disease was diagnosed with hemophagocytic lymphohistiocytosis through a bone marrow biopsy.
- Timely treatment led to significant clinical improvement in the patient.
- The case highlights the importance of considering HLH in adults with hematologic abnormalities and systemic inflammation.

## Abstract

Hemophagocytic lymphohistiocytosis (HLH) is a rare but potentially life-threatening syndrome characterized by excessive immune activation and tissue inflammation. This case report describes the early diagnosis of HLH in an adult patient who initially presented with a febrile syndrome associated with low back pain. The patient, a 33-year-old male, exhibited bicytopenia, hepatosplenomegaly, and hyperferritinemia without a previous diagnosis of sickle cell disease (SCD). Diagnostic challenges arose due to the overlapping clinical manifestations of SCD and HLH and their uncommon association. However, timely recognition and intervention were achieved through comprehensive diagnostic evaluations, including a bone marrow biopsy. The patient was promptly started on an appropriate therapeutic regimen, which led to significant clinical improvement. This case underscores the importance of considering HLH in the differential diagnosis of adults presenting with hematologic abnormalities and systemic inflammation. Early diagnosis and treatment are critical to improving outcomes for patients with this complex and severe disorder.