{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T22:29:38Z","timestamp":1792794578224,"version":"4.5.0"},"reference-count":14,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2015,3,2]]},"abstract":"<jats:p>Haemophagocytic lymphohistiocytosis (HLH) is a rare, potentially fatal condition that can be primary or secondary. Secondary HLH can occur in association with infections, most commonly viral infections, but has also been reported in association with<jats:italic>Mycobacterium tuberculosis<\/jats:italic>(TB). Prompt identification of the underlying cause of HLH is important as it guides treatment decisions. Early initiation of appropriate treatment (eg, anti-TB treatment) reduces morbidity and mortality. We present a case of HLH associated with TB infection. Initial TB investigations were negative and standard combination chemoimmunotherapy for HLH resulted in a limited clinical response. On apparent relapse of HLH, further investigation revealed TB with changes on CT chest, granuloma on bone marrow and eventual positive TB culture on bronchoalveolar lavage. Subsequent treatment with quadruple anti-TB treatment resulted in rapid clinical response and disease remission. We advocate continued monitoring for TB infection in patients with HLH, and prophylaxis or full treatment for those at high risk.<\/jats:p>","DOI":"10.1136\/bcr-2014-208220","type":"journal-article","created":{"date-parts":[[2015,4,13]],"date-time":"2015-04-13T08:01:04Z","timestamp":1428912064000},"page":"bcr2014208220","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":20,"title":["Haemophagocytic lymphohistiocytosis associated with<i>Mycobacterium tuberculosis<\/i>infection"],"prefix":"10.1136","volume":"2015","author":[{"given":"Yee Man Tracy","family":"Hui","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toby","family":"Pillinger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asad","family":"Luqmani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nichola","family":"Cooper","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2015,4,13]]},"reference":[{"key":"2025042705580786000_2015.apr13_1.bcr2014208220.1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(07)70290-6"},{"key":"2025042705580786000_2015.apr13_1.bcr2014208220.2","doi-asserted-by":"publisher","DOI":"10.1016\/S0889-8588(05)70521-9"},{"key":"2025042705580786000_2015.apr13_1.bcr2014208220.3","doi-asserted-by":"publisher","DOI":"10.3201\/eid0606.000608"},{"key":"2025042705580786000_2015.apr13_1.bcr2014208220.4","doi-asserted-by":"crossref","unstructured":"Filipovich AH . Hemophagocytic lymphohistiocytosis (HLH) and related disorders. Hematology Am Soc Hematol Educ Program 2009:127\u201331. doi:10.1182\/asheducation-2009.1.127","DOI":"10.1182\/asheducation-2009.1.127"},{"key":"2025042705580786000_2015.apr13_1.bcr2014208220.5","unstructured":"Histiocyte Society Hemophagocytic Lymphohistiocytosis Study Group. Treatment Protocol of the Second International HLH Study 2004. http:\/\/www.uni-ulm.de\/expane\/docs\/HLH%202004%20Study%20Protocol.pdf (accessed 19 May 2014)."},{"key":"2025042705580786000_2015.apr13_1.bcr2014208220.6","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.21039"},{"key":"2025042705580786000_2015.apr13_1.bcr2014208220.7","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbmt.2009.11.014"},{"key":"2025042705580786000_2015.apr13_1.bcr2014208220.8","doi-asserted-by":"publisher","DOI":"10.1016\/S1568-9972(03)00091-0"},{"key":"2025042705580786000_2015.apr13_1.bcr2014208220.9","doi-asserted-by":"publisher","DOI":"10.1038\/bmt.2008.232"},{"key":"2025042705580786000_2015.apr13_1.bcr2014208220.10","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(06)70524-2"},{"key":"2025042705580786000_2015.apr13_1.bcr2014208220.11","first-page":"517","article-title":"Haemophagocytic lymphohistiocytosis: an uncommon clinical presentation of tuberculosis","volume":"18","author":"Shea","year":"2012","journal-title":"Hong Kong Med J"},{"key":"2025042705580786000_2015.apr13_1.bcr2014208220.12","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1097\/01.mej.0000190275.85107.55","article-title":"Life-threatening hemophagocytic syndrome related to mycobacterium tuberculosis","volume":"13","author":"Claessens","year":"2005","journal-title":"Eur J Emerg Med"},{"key":"2025042705580786000_2015.apr13_1.bcr2014208220.13","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(11)70210-9"},{"key":"2025042705580786000_2015.apr13_1.bcr2014208220.14","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.1086"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2014-208220","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,27]],"date-time":"2025-04-27T12:58:20Z","timestamp":1745758700000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2014-208220"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,4,13]]},"references-count":14,"alternative-id":["10.1136\/bcr-2014-208220"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2014-208220","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,4,13]]}}}