Haemophagocytic Lymphohistiocytosis Triggered by Visceral Leishmaniasis Masquerading as Epstein-Barr Virus (EBV)-Associated Haemophagocytic Lymphohistiocytosis in Rheumatoid Arthritis: A Case Report and Literature Review. (PubMed, Cureus) - Oct 12, 2026 - "Visceral leishmaniasis (VL) is a systemic parasitic infection that may mimic or trigger HLH, particularly in immunosuppressed patients. We report a 59-year-old man with seropositive rheumatoid arthritis, for which he received immunosuppressive treatment with methotrexate and etanercept. For eosinophilic asthma, he was treated with benralizumab...Further laboratory findings showed progressive hyperferritinaemia, hypofibrinogenaemia, and hypertriglyceridaemia, together with haemophagocytosis on bone marrow examination, which supported the diagnosis of secondary HLH. Because Epstein-Barr virus (EBV) DNA was detected in peripheral blood, EBV-associated HLH was initially suspected, and treatment was started with rituximab, targeting potentially EBV-infected B cells, and dexamethasone to suppress the hyperinflammatory response...Treatment was redirected to liposomal amphotericin B; further HLH-directed immunosuppressive therapy was withheld, and..."
Journal • Asthma • Dyslipidemia • Epstein-Barr Virus Infections • Hematological Disorders • Hemophagocytic lymphohistiocytosis • Immunology • Infectious Disease • Inflammatory Arthritis • Oncology • Pulmonary Disease • Rare Diseases • Respiratory Diseases • Rheumatoid Arthritis • Rheumatology
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Eef Vanerwegen; Frederik Fleurinck; Liesbet Henckaerts; Mariëlle Beckers; Patrick Verschueren
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