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Due to its rare occurrence and being more frequent in infants and the paediatric population, the literature lacks enough data to standardise therapies. Such events in adults and the elderly are invariably related to an underlying insult such as infections, other autoimmune or rheumatological diseases or drugs. We describe an interesting case of a middle-aged Caucasian woman who presented with fever, pancytopenia and hepatitis, who was eventually diagnosed with HLH just in time to receive the life-saving specific treatment as per available guidelines.<\/jats:p>","DOI":"10.1136\/bcr-2021-245835","type":"journal-article","created":{"date-parts":[[2022,3,9]],"date-time":"2022-03-09T11:18:22Z","timestamp":1646824702000},"page":"e245835","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Lamotrigine-associated haemophagocytic lymphohistiocytosis (HLH) confounded with underlying rheumatoid arthritis"],"prefix":"10.1136","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0024-290X","authenticated-orcid":false,"given":"Dhivya","family":"Velu","sequence":"first","affiliation":[{"name":"Internal Medicine, UAB Huntsville Regional Medical Campus, Huntsville, Alabama, 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