Infect Chemother.  2021 Dec;53(4):802-807. 10.3947/ic.2018.0203.

A Case of Human Immunodeficiency Virus -triggered Hemophagocytic Lymphohistocytosis Presenting with Severe Bleeding Tendency

  • 1Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea


Human immunodeficiency virus (HIV) is one of the less common triggers of secondary hemophagocytic lymphohistiocytosis (HLH) in which coagulation disorder is a frequent manifestation. Here, we present a case of HIV-triggered secondary HLH presenting with severe bleeding tendency and fever. Despite high-dose dexamethasone infusion (10 mg/body surface area/day), progressive disseminated intravascular coagulation and thrombocytopenia resulted in massive hemathochezia: the bleeding episode ceased after endoscopic hemoclipping. After then, he took a highly-active antiretroviral therapy (HAART). Eventually, body temperature and overall laboratory findings normalized in response to HAART. Clinicians should not overlook HIV infection as a possible trigger of secondary HLH. In such cases, HAART is the core treatment.


Human immunodeficiency virus; Acquired immune deficiency syndrome; Antiviral
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