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In 2019, a UK-wide HLH network was developed to provide specialist advice for patients with HLH. Until September 2024, eight individuals had been referred to this service with HLH onset during pregnancy or within 6 months postpartum, and this article summarises their management. Shared themes were of postpartum predominance, with onset typically within a month of delivery, preceding infection, and underlying immune dysfunction. Common therapies included corticosteroids and the interleukin-1 receptor antagonist, anakinra. Most individuals required level 3 care, three were considered for extracorporeal membrane oxygenation, and one died. HLH should be included in the differential of maternal sepsis, given all cases presented with fever and organ dysfunction, particularly if there is ongoing deterioration despite antimicrobial therapy and\/or without an identified source.<\/jats:p>","DOI":"10.1177\/1753495x251356108","type":"journal-article","created":{"date-parts":[[2025,7,8]],"date-time":"2025-07-08T04:27:04Z","timestamp":1751948824000},"page":"115-120","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Haemophagocytic lymphohistiocytosis in pregnancy and the postpartum: A case series from the national HLH network"],"prefix":"10.1177","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9701-190X","authenticated-orcid":false,"given":"Bethan","family":"Goulden","sequence":"first","affiliation":[{"name":"University College London"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eleanor","family":"Singer","sequence":"additional","affiliation":[{"name":"Queen Elizabeth University Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin","family":"Bennett","sequence":"additional","affiliation":[{"name":"West Middlesex University Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-2688-5014","authenticated-orcid":false,"given":"Eman","family":"Elfar","sequence":"additional","affiliation":[{"name":"Kings College London Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazi","family":"Fardeen","sequence":"additional","affiliation":[{"name":"Royal Free Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8913-3894","authenticated-orcid":false,"given":"Ian","family":"Giles","sequence":"additional","affiliation":[{"name":"University College London"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Rankin","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, University Hospitals Birmingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanna","family":"Girling","sequence":"additional","affiliation":[{"name":"West Middlesex University Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harry","family":"Suzuki","sequence":"additional","affiliation":[{"name":"Queen Elizabeth University Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kate","family":"Wiles","sequence":"additional","affiliation":[{"name":"Barts Health NHS Trust"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-3547-6442","authenticated-orcid":false,"given":"Maria","family":"Mouyis","sequence":"additional","affiliation":[{"name":"Bedfordshire NHS Foundation Trust"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel","family":"Tattersall","sequence":"additional","affiliation":[{"name":"Sheffield Teaching Hospitals NHS Foundation Trust"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4955-7929","authenticated-orcid":false,"given":"Alexis","family":"Jones","sequence":"additional","affiliation":[{"name":"University College London Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica","family":"Manson","sequence":"additional","affiliation":[{"name":"University College London Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,7,8]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra2314005"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2665-9913(23)00273-4"},{"key":"e_1_3_2_4_2","unstructured":"Lanyon P Lesley K and on behalf of Getting it Right First Time. Haemophagocytic Lymphohistiocytosis (HLH): Guidance on the diagnosis treatment management and governance. [Internet]. 2024 Jul [cited 2025 Mar 13]. Available from: https:\/\/gettingitrightfirsttime.co.uk\/wp-content\/uploads\/2024\/07\/HLH-Guide-final-version-v1.1-July-2024.pdf."},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1093\/ajcp\/aqw076"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1002\/art.38690"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2023.07.023"},{"key":"e_1_3_2_8_2","unstructured":"Knight M Bunch K Felker A et al. on behalf of MBRRACE-UK. Saving Lives Improving Mothers\u2019 Care Core Report - Lessons learned to inform maternity care from the UK and Ireland Confidential Enquiries into Maternal Deaths and Morbidity 2019-21 [Internet]. University of Oxford: National Perinatal Epidemiology Unit; 2023 [cited 2025 Mar 12]. 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