A Case of DILI and Subsequent HLH Induced by Allopurinol

Hemophagocytic lymphohistiocytosis (HLH) is a syndrome that occurs because of uncontrolled immune cell activation and can present as a primary or acquired disorder. It is an illness with a high mortality rate that has been increasing in incidence over the past decade. There are few reports of allopurinol-induced HLH. This case describes a patient who was initially diagnosed with drug-induced liver injury secondary to allopurinol and subsequently diagnosed with HLH secondary to allopurinol. The discussion highlights the pathophysiology, clinical findings, diagnostic work-up, and treatment of HLH, along with mentioning interventions that focus on prevention of these diseases.