{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T17:16:04Z","timestamp":1761844564689,"version":"3.40.4"},"reference-count":17,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2015,10,12]]},"abstract":"<jats:p>The differential diagnosis of febrile pancytopenia in the setting of HIV infection can be challenging. The authors report a case of a 34-year-old man with advanced HIV infection (TCD4=8 cells\/mm<jats:sup>3<\/jats:sup>) and a 2-month history of fever, weight loss and asthaenia. On observation, he was emaciated, hyperthermic and pale, with a haemorrhagic oropharyngeal lesion, penile violaceous lesions and palpable hepatosplenomegaly. Blood tests showed pancytopenia, hyperferritinaemia and hypertriglyceridaemia; imaging confirmed hepatosplenomegaly and a bone marrow biopsy revealed HIV-associated dyshematopoiesis. Biopsy of the aforementioned lesions displayed Kaposi sarcoma; extensive investigation was negative for other opportunistic infections or lymphoproliferative disease. Despite only a posteriori histological documentation, haemophagocytic lymphohistiocytosis (HLH) was considered; chemotherapy and antiretrovirals were started, with excellent response. There was, however, disease relapse requiring an intensification course, with sustained remission at 18-month follow-up. HLH is a rare disease, with non-specific presentation, requiring a high index of suspicion since treatment delay can be fatal.<\/jats:p>","DOI":"10.1136\/bcr-2015-211817","type":"journal-article","created":{"date-parts":[[2015,10,28]],"date-time":"2015-10-28T15:23:04Z","timestamp":1446045784000},"page":"bcr2015211817","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":11,"title":["The challenging diagnosis of haemophagocytic lymphohistiocytosis in an HIV-infected patient"],"prefix":"10.1136","volume":"2015","author":[{"given":"Lu\u00edsa","family":"Azevedo","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rita","family":"Gerivaz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joana","family":"Sim\u00f5es","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Isabel","family":"Germano","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2015,10,28]]},"reference":[{"key":"2025042707310103000_2015.oct28_1.bcr2015211817.1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2141.1997.2943111.x"},{"key":"2025042707310103000_2015.oct28_1.bcr2015211817.2","doi-asserted-by":"crossref","first-page":"194","DOI":"10.1016\/S0140-6736(00)61951-7","article-title":"Histiocytic medullary reticulosis","volume":"2","author":"Scott","year":"1939","journal-title":"Lancet"},{"key":"2025042707310103000_2015.oct28_1.bcr2015211817.3","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.21039"},{"key":"2025042707310103000_2015.oct28_1.bcr2015211817.4","doi-asserted-by":"publisher","DOI":"10.1309\/AJCP4ZDKJ4ICOUAT"},{"key":"2025042707310103000_2015.oct28_1.bcr2015211817.5","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-med-041610-134208"},{"key":"2025042707310103000_2015.oct28_1.bcr2015211817.6","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(07)70290-6"},{"key":"2025042707310103000_2015.oct28_1.bcr2015211817.7","doi-asserted-by":"publisher","DOI":"10.1002\/rmv.638"},{"key":"2025042707310103000_2015.oct28_1.bcr2015211817.8","doi-asserted-by":"publisher","DOI":"10.1097\/QCO.0b013e32832180b0"},{"key":"2025042707310103000_2015.oct28_1.bcr2015211817.9","doi-asserted-by":"publisher","DOI":"10.1097\/01.qai.0000136725.92886.b8"},{"key":"2025042707310103000_2015.oct28_1.bcr2015211817.10","doi-asserted-by":"publisher","DOI":"10.1080\/00365540410020569"},{"key":"2025042707310103000_2015.oct28_1.bcr2015211817.11","doi-asserted-by":"publisher","DOI":"10.1016\/j.jinf.2011.08.011"},{"key":"2025042707310103000_2015.oct28_1.bcr2015211817.12","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.21423"},{"key":"2025042707310103000_2015.oct28_1.bcr2015211817.13","doi-asserted-by":"publisher","DOI":"10.1016\/S0248-8663(97)81959-5"},{"key":"2025042707310103000_2015.oct28_1.bcr2015211817.14","first-page":"727","article-title":"Acquired immunodeficiency syndrome. 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