Abstract

Haemophagocytic lymphohistiocytosis (HLH) is an uncommon serious hematological disorder marked by tissue destruction and extreme inflammation brought on by abnormal immune system activation. It can manifest as primary (hereditary) in infants/young children or secondary, often associated with infections, malignancy, and autoimmune disorders. We present a case of HLH secondary to lymphoma in an elderly patient, highlighting the diagnostic challenges and clinical complexities encountered in this age group. Our 85-year-old male patient presented with persistent fever, generalized weakness, and abnormal laboratory findings, including pancytopenia and markedly elevated ferritin levels. Despite extensive investigations, including imaging studies and bone marrow biopsy, the diagnosis was challenging due to overlapping clinical features. The patient’s clinical course was further complicated by COVID-19 infection, necessitating a palliative care approach. This case underscores the importance of early recognition and multidisciplinary management in optimizing outcomes for HLH, especially in elderly patients with comorbidities.