{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T05:00:32Z","timestamp":1790312432398,"version":"4.1.0"},"reference-count":10,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T00:00:00Z","timestamp":1790294400000},"content-version":"vor","delay-in-days":24,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,9,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Haemophagocytic Lymphohistiocytosis (HLH) causes life-threatening hyperinflammation and has conventionally been treated with glucocorticoids plus additional immunosuppression such as ciclosporin and anakinra. We describe the case of a 47-year-old female who presented to a DGH with HLH secondary to both Systemic Lupus Erythematosus (SLE) and Covid infection. Her disease relapsed despite an initial response to first-line treatment including glucocorticoids, ciclosporin, intravenous immunoglobulins (IVIG) and conventional doses of anakinra. She subsequently responded to a higher dose of anakinra, resulting in sustained remission. This case illustrates the potentially life-saving difference between conventional and higher anakinra doses in severe HLH- an observation that is consistent with other reported cases of HLH with different triggers. We argue, therefore, for high-dose anakinra to be used first-line in refractory HLH, given the high mortality of the disease, while also carefully monitoring for infections post-interleukin-1-blockade. This adds weight to the shifting national treatment paradigm in this direction.<\/jats:p>","DOI":"10.1093\/omcr\/omag130","type":"journal-article","created":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T11:35:06Z","timestamp":1788867306000},"source":"Crossref","is-referenced-by-count":0,"title":["Rapid response to high-dose Anakinra in refractory SLE-associated Haemophagocytic Lymphohistiocytosis: a case report"],"prefix":"10.1093","volume":"2026","author":[{"given":"S","family":"Jain","sequence":"first","affiliation":[{"name":"Department of Rheumatology, Royal Berkshire Hospital, London Road, Reading , Berkshire , RG1 5AN,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N","family":"Soe","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, University Hospital Coventry and Warwickshire , Clifford Bridge Road, Coventry, Warwickshire , CV2 2DX,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-6345-0289","authenticated-orcid":false,"given":"K","family":"Sandhu","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Royal Berkshire Hospital, London Road, Reading , Berkshire , RG1 5AN,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J","family":"McNally","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Royal Berkshire Hospital, London Road, Reading , Berkshire , RG1 5AN,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,9,25]]},"reference":[{"key":"2026092500380874100_ref1","volume-title":"Guidance on the diagnosis, treatment, management and 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