{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,21]],"date-time":"2026-02-21T07:02:20Z","timestamp":1771657340126,"version":"3.50.1"},"reference-count":16,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2017,9,21]]},"abstract":"<jats:p>Hemophagocytic lymphohistiocytosis (HLH) is a serious life-threatening disease if not recognised early. In patients with HIV\/AIDS, this association has been reported following acute opportunistic infections, including histoplasmosis. However, optimal treatment is not known. We describe a male aged 46 years with AIDS who developed HLH following acute disseminated histoplasmosis. Presenting symptoms included fever, hepatosplenomegaly and pancytopenia. Bone marrow biopsy confirmed HLH. Initially, he was refractory to the treatment with amphotericin B, antiretroviral therapy and intravenous immunoglobulin (IVIG). Anakinra, an interleukin-1 receptor antagonist, and dexamethasone were initiated. He improved clinically, did not exhibit any harmful effects and ultimately was discharged from the hospital. This, we believe, is the first reported treatment of HLH with anakinra in a patient with AIDS and acute disseminated histoplasmosis.<\/jats:p>","DOI":"10.1136\/bcr-2017-221264","type":"journal-article","created":{"date-parts":[[2017,10,4]],"date-time":"2017-10-04T07:25:46Z","timestamp":1507101946000},"page":"bcr-2017-221264","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":18,"title":["Safe usage of anakinra and dexamethasone to treat refractory hemophagocytic lymphohistiocytosis secondary to acute disseminated histoplasmosis in a patient with HIV\/AIDS"],"prefix":"10.1136","volume":"2017","author":[{"given":"Anthony J","family":"Ocon","sequence":"first","affiliation":[{"name":"Division of Rheumatology, Department of Medicine, Albany Medical Center, Albany, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Birju D","family":"Bhatt","sequence":"additional","affiliation":[{"name":"Division of Rheumatology, Department of Medicine, Albany Medical Center, Albany, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cynthia","family":"Miller","sequence":"additional","affiliation":[{"name":"Division of Infectious Disease, Department of Medicine, Albany Medical Center, Albany, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ruben A","family":"Peredo","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Albany Medical Center, Albany, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2017,10,4]]},"reference":[{"key":"2025082704000253000_2017.oct03_1.bcr-2017-221264.1","doi-asserted-by":"crossref","first-page":"411","DOI":"10.1016\/j.blre.2016.05.001","article-title":"Hemophagocytic syndromes (HPSs) including hemophagocytic lymphohistiocytosis (HLH) in adults: a systematic scoping review","volume":"30","author":"Hayden","year":"2016","journal-title":"Blood Rev"},{"key":"2025082704000253000_2017.oct03_1.bcr-2017-221264.2","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.21039"},{"key":"2025082704000253000_2017.oct03_1.bcr-2017-221264.3","doi-asserted-by":"crossref","unstructured":"Azevedo L , Gerivaz R , Sim\u00f5es J , et al . The challenging diagnosis of haemophagocytic lymphohistiocytosis in an HIV-infected patient. 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Interleukin 1 receptor antagonist anakinra, intravenous immunoglobulin, and corticosteroids in the management of critically ill adult patients with hemophagocytic lymphohistiocytosis. 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