Case Report
Hemophagocytic Lymphohistiocytosis (HLH) in a Patient with Disseminated Histoplasmosis
Table 1
Patient’s trend of laboratory values during course of admission.
| | Day | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 | 11 | 12 | 13 | 14 | 15 | 16 | 17 | 18 | 19 |
| | ALP (IU/L) | 227 | 241 | 247 | 326 | 349 | 405 | 503 | 557 | 475 | 475 | 584 | 877 | 484 | 470 | 444 | 355 | 233 | 197 | 143 | | Total bilirubin (mg/dL) | 7.5 | 9.4 | 10.2 | 9.9 | 8.9 | 9.3 | 8.7 | 8.4 | 6.8 | 5.9 | 5.7 | 7.1 | 5.8 | 5.2 | 5.6 | 4.4 | 4.3 | 4.2 | 3.7 | | Direct bilirubin (mg/dL) | 6.0 | 7.0 | 8.0 | 7.1 | 6.6 | 6.4 | 6.1 | 6.2 | 5.2 | 4.7 | 4.6 | 5.5 | 4.3 | 2.9 | 4.1 | 3.2 | 3.1 | 3.2 | 2.8 | | ALT (IU/L) | 272 | 340 | 466 | 405 | 366 | 428 | 446 | 400 | 328 | 242 | 247 | 246 | 185 | 172 | 142 | 105 | 75 | 55 | 39 | | AST (IU/L) | 712 | 965 | 1827 | 1379 | 1319 | 1935 | 1718 | 1288 | 818 | 416 | 358 | 284 | 151 | 119 | 87 | 64 | 43 | 37 | 27 | | Ferritin (ng/mL) | >40,000 | >40,000 | >40,000 | >40,000 | >40,000 | >40,000 | >40,000 | >40,000 | >40,000 | 35548 | 16993 | 11886 | 8775 | 6157 | 4609 | 2990 | 1918 | 1521 | 1425 | | WBC (×103/mcL) | 2.73 | 2.91 | 2.97 | 1.70 | 1.41 | 2.62 | 5.25 | 9.67 | 9.64 | 9.96 | 10.73 | 11.81 | 11.37 | 10.66 | 9.87 | 9.29 | 7.52 | 9.44 | 9.79 | | Absolute lymphocyte count (cells/mm3) | 410 | | | | | | | 1793 | | 1827 | | 2350 | | 1978 | | 1858 | | 1888 | | | Hemoglobin 0 (g/dL) | 7.8 | 6.9 | 7.2 | 6.8 | 7.1 | 7.1 | 8.4 | 7.5 | 7.7 | 6.9 | 7.9 | 6.4 | 7.7 | 7.4 | 7.3 | 7.2 | 6.0 | 5.0 | 3.8 | | Platelet (×103/mcL) | 40 | 53 | 57 | 85 | 91 | 105 | 110 | 125 | 128 | 113 | 72 | 75 | 57 | 36 | 44 | 55 | 58 | 42 | 30 | | Fibrinogen (mg/dL) | 78 | 60 | 90 | 120 | 206 | 353 | 293 | 292 | 296 | 294 | 220 | 201 | 217 | 181 | 172 | 183 | 273 | 177 | 91 | | INR | 2.5 | 2.4 | 1.7 | 1.4 | 1.5 | 1.2 | 1.2 | 1.2 | 1.1 | 1.1 | 1.3 | 1.1 | 1.1 | 1.2 | 1.2 | 1.2 | 1.5 | 1.9 | 2 |
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ALP, alkaline phosphatase; ALT, alanine transaminase; AST, aspartate transaminase; WBC, white blood cell.
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