# Hemophagocytic Lymphohistiocytosis and the Liver Masquerade

## TL;DR

This case report describes a rare and complex case of hemophagocytic lymphohistiocytosis (HLH) that presented with liver symptoms and blood cell deficiencies, highlighting the difficulty in diagnosing such conditions.

## Contribution

The paper contributes a rare case of HLH with atypical liver presentation, emphasizing diagnostic challenges in similar clinical scenarios.

## Key findings

- HLH can present with liver symptoms and pancytopenia, mimicking other conditions.
- Chronic alcohol use disorder can complicate the clinical picture and delay diagnosis.
- Early clinical suspicion and thorough investigation are crucial for diagnosing HLH.

## Abstract

We present a case of hemophagocytic lymphohistiocytosis (HLH) with a complex presentation that could have been easily mistaken as one of many alternative diagnoses. Our patient, with chronic alcohol use disorder, presented with new-onset liver symptoms and pancytopenia. This case underscores the importance of clinical suspicion and further investigation of a wide differential. The purpose of this case report is to highlight the diagnostic challenges and nuances in patient presentation that can mislead healthcare providers while emphasizing the ambiguity of liver failure symptoms in patients with undiagnosed HLH.