67th Myanmar Medical Conference JOB OPPORTUNITIES

Haemophagocytic lymphohistiocytosis

Swe Zin Hlaing1, Saw Win2, Aung Khin Thein3

 

Published in Volume 68, No. 1, 2026 January – March issue

https://doi.org/10.64455/xmma0020

 

A two-year-old boy from a district hospital was admitted to Parami General Hospital with a febrile illness. He presented with high fever, diarrhoea, mucocutaneous manifestations, and high inflammatory markers. Initially he was diagnosed as Multisystem Inflammatory Syndrome in Children (MIS-C) and treated accordingly.

 

Although intravenous immunoglobulin and corticosteroid were given, he did not respond to the treatment and developed splenomegaly. Further evaluation and bone marrow aspiration revealed haemophagocytosis and he was finally diagnosed as Haemophagocytic Lymphohistiocytosis (HLH). He was subsequently treated according to HLH protocol and responded well.

 

This case highlights the need for heightened clinical suspicion of HLH in MIS-C patients unresponsive to standard therapies. The patient’s initial presentation mimicked MIS-C, but persistent inflammation and fever, anaemia, splenomegaly, treatment unresponsiveness and bone marrow involvement warranted further evaluation, ultimately leading to the HLH diagnosis.

 

  1. Senior Medical officer, Parami General Hospital, Yangon, Myanmar
  2. Professor/Senior Consultant Paediatrician, Parami General Hospital, Yangon, Myanmar
  3. Senior Consultant Paediatrician, Yankin Children Hospital, Yangon, Myanmar

Corresponding author: [email protected]