{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T23:06:56Z","timestamp":1792796816912,"version":"4.5.0"},"reference-count":15,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2023,12,30]],"date-time":"2023-12-30T00:00:00Z","timestamp":1703894400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of the Royal College of Physicians of Edinburgh"],"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:p>Haemophagocytic lymphohistiocytosis (HLH) is a rare, aggressive, excess immune activation syndrome. Diagnosis can be challenging due to its several clinical mimics including sepsis. There are multiple aetiologies of HLH; in adults, it is most commonly triggered by infection, malignancy, drugs and autoimmune processes. Failure to rapidly diagnose and treat this condition can be fatal. The management of HLH includes identifying and removing the trigger, supportive management and immunosuppression. Identifying the trigger is essential to inform the most appropriate type of immunosuppression. Here, we report a case of likely drug-induced HLH in a patient recently treated for hairy cell leukaemia. The culprit drug was thought to be co-trimoxazole and this case report highlights a very rare complication of this commonly used drug. We discuss our management approach with steroid monotherapy and withdrawal of co-trimoxazole.<\/jats:p>","DOI":"10.1177\/14782715231220108","type":"journal-article","created":{"date-parts":[[2023,12,30]],"date-time":"2023-12-30T22:23:14Z","timestamp":1703974994000},"page":"29-33","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":5,"title":["Drug-induced secondary haemophagocytic lymphohistiocytosis in hairy cell leukaemia"],"prefix":"10.1177","volume":"54","author":[{"given":"Katherine","family":"Stark","sequence":"first","affiliation":[{"name":"Department of Haematology, Aberdeen Royal Infirmary, NHS Grampian, Aberdeen, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cormac","family":"Rowe","sequence":"additional","affiliation":[{"name":"Department of Haematology, Aberdeen Royal Infirmary, NHS Grampian, Aberdeen, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abhinav","family":"Mathur","sequence":"additional","affiliation":[{"name":"Department of Haematology, Aberdeen Royal Infirmary, NHS Grampian, Aberdeen, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Matossian","sequence":"additional","affiliation":[{"name":"Department of Pathology, Aberdeen Royal Infirmary, NHS Grampian, Aberdeen, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alastair","family":"Lawrie","sequence":"additional","affiliation":[{"name":"Department of Haematology, Aberdeen Royal Infirmary, NHS Grampian, Aberdeen, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2023,12,30]]},"reference":[{"key":"bibr1-14782715231220108","doi-asserted-by":"publisher","DOI":"10.1182\/asheducation-2015.1.177"},{"key":"bibr2-14782715231220108","doi-asserted-by":"publisher","DOI":"10.1182\/asheducation-2013.1.605"},{"key":"bibr3-14782715231220108","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.17055"},{"key":"bibr4-14782715231220108","doi-asserted-by":"publisher","DOI":"10.1002\/art.38690"},{"key":"bibr5-14782715231220108","unstructured":"NHS England. Clinical Commissioning Policy: Anakinra for Haemophagocytic Lymphohistiocytosis (HLH) for adults and children in all ages. 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