{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T12:24:35Z","timestamp":1756383875895,"version":"3.44.0"},"reference-count":15,"publisher":"BMJ","issue":"2","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2018,12,27]]},"published-print":{"date-parts":[[2019,2]]},"abstract":"<jats:p>We present a case of haemophagocytic lymphohistiocytosis (HLH) in the context of disseminated cytomegalovirus (CMV) viraemia in a 50-year-old man with well-controlled HIV infection and ulcerative colitis (UC), for which he was receiving azathioprine. Peak CMV viral load was 371 000 copies\/ml with evidence of end-organ CMV in the lungs and colon. A bone marrow biopsy showed evidence of haemophagocytosis of platelets, neutrophils and erythrocytes. The azathioprine was stopped, and he received intravenous ganciclovir and corticosteroids with suppression of the CMV viral load and resolution of the HLH.<\/jats:p>","DOI":"10.1136\/bcr-2018-227916","type":"journal-article","created":{"date-parts":[[2019,2,14]],"date-time":"2019-02-14T00:27:42Z","timestamp":1550104062000},"page":"e227916","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":8,"title":["Disseminated CMV infection and HLH in a patient with well-controlled HIV and ulcerative colitis"],"prefix":"10.1136","volume":"12","author":[{"given":"Beatrice Clare","family":"Cockbain","sequence":"first","affiliation":[{"name":"Department of Immmunology and Infection, Barts Health NHS Trust, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Borja","family":"Mora Peris","sequence":"additional","affiliation":[{"name":"Department of Genitourinary Medicine and HIV, Imperial College Healthcare NHS Trust, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aula","family":"Abbara","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Imperial College Healthcare NHS Trust, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chun Wah","family":"So","sequence":"additional","affiliation":[{"name":"Department of Radiology, Northwick Park Hospital, Harrow, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Graham","family":"Cooke","sequence":"additional","affiliation":[{"name":"Department of Genitourinary Medicine and HIV, Imperial College Healthcare NHS Trust, London, UK"},{"name":"Department of Infectious Diseases, Imperial College Healthcare NHS Trust, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2019,7,11]]},"reference":[{"key":"2025082702293678000_12.2.e227916.1","doi-asserted-by":"crossref","first-page":"69","DOI":"10.2147\/JBM.S46255","article-title":"Hemophagocytic lymphohistiocytosis: review of etiologies and management","volume":"5","author":"George","year":"2014","journal-title":"J Blood Med"},{"key":"2025082702293678000_12.2.e227916.2","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1097\/SHK.0000000000001048","article-title":"Hemophagocytic Lymphohistiocytosis: Potentially Underdiagnosed in Intensive Care Units","volume":"50","author":"Lachmann","year":"2018","journal-title":"Shock"},{"key":"2025082702293678000_12.2.e227916.3","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.21039"},{"key":"2025082702293678000_12.2.e227916.4","doi-asserted-by":"publisher","DOI":"10.1002\/art.11368"},{"key":"2025082702293678000_12.2.e227916.5","doi-asserted-by":"crossref","first-page":"19","DOI":"10.3390\/tropicalmed3010019","article-title":"Hemophagocytic lymphohistiocytosis associated with scrub typhus: systematic review and comparison between pediatric and adult cases","volume":"3","author":"Naoi","year":"2018","journal-title":"Trop Med Infect Dis"},{"key":"2025082702293678000_12.2.e227916.6","doi-asserted-by":"crossref","unstructured":"Wohlfarth P , Agis H , Gualdoni GA , et al . Interleukin 1 Receptor Antagonist Anakinra, Intravenous Immunoglobulin, and Corticosteroids in the Management of Critically Ill Adult Patients With Hemophagocytic Lymphohistiocytosis. J Intensive Care Med 2017:088506661771138.doi:10.1177\/0885066617711386","DOI":"10.1177\/0885066617711386"},{"key":"2025082702293678000_12.2.e227916.7","doi-asserted-by":"crossref","first-page":"e77","DOI":"10.1016\/j.clinre.2018.03.012","article-title":"Early onset lysosomal acid lipase deficiency presenting as secondary hemophagocytic lymphohistiocytosis: two infants treated with sebelipase alfa","volume":"42","author":"Santos Silva","year":"2018","journal-title":"Clin Res Hepatol Gastroenterol"},{"key":"2025082702293678000_12.2.e227916.8","first-page":"e1070","article-title":"Acute Cytomegalovirus (CMV) infection associated with hemophagocytic lymphohistiocytosis (hlh) in an immunocompetent host meeting all eight HLH 2004 diagnostic criteria","volume":"9","author":"Bonnecaze","year":"2017","journal-title":"Cureus"},{"key":"2025082702293678000_12.2.e227916.9","doi-asserted-by":"crossref","first-page":"633","DOI":"10.1186\/s12879-017-2732-y","article-title":"Acute HIV infection presenting as hemophagocytic lymphohistiocytosis: case report and review of the literature","volume":"17","author":"Manji","year":"2017","journal-title":"BMC Infect Dis"},{"key":"2025082702293678000_12.2.e227916.10","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. BMJ Case Rep 2015:bcr2015211817.doi:10.1136\/bcr-2015-211817","DOI":"10.1136\/bcr-2015-211817"},{"key":"2025082702293678000_12.2.e227916.11","doi-asserted-by":"crossref","first-page":"bcr-2017-221264","DOI":"10.1136\/bcr-2017-221264","article-title":"Safe usage of anakinra and dexamethasone to treat refractory hemophagocytic lymphohistiocytosis secondary to acute disseminated histoplasmosis in a patient with HIV\/AIDS","volume":"2017","author":"Ocon","year":"2017","journal-title":"BMJ Case Rep"},{"key":"2025082702293678000_12.2.e227916.12","first-page":"1","article-title":"Hemophagocytic Lymphohistiocytosis Complicating T-Cell Lymphoma in a Patient with HIV Infection","volume":"2013","author":"Uemura","year":"2013","journal-title":"Case Rep Hematol"},{"key":"2025082702293678000_12.2.e227916.13","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2011.04.045"},{"key":"2025082702293678000_12.2.e227916.14","doi-asserted-by":"publisher","DOI":"10.1097\/PCC.0000000000000078"},{"key":"2025082702293678000_12.2.e227916.15","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2007.083188"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2018-227916","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T09:29:46Z","timestamp":1756286986000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2018-227916"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,2]]},"references-count":15,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2019,7,11]]},"published-print":{"date-parts":[[2019,2]]}},"alternative-id":["10.1136\/bcr-2018-227916"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2018-227916","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2019,2]]}}}