Secondary hemophagocytic lymphohistiocytosis and autoimmune cytopenias: Case description and review of the literature

：Hemophagocytic lymphohistocytosis (HLH) is a rare hyperinflammatory condition which may be primary or secondary to many diseases, including hematologic malignancies. Due to its life-threatening evolution, a timely diagnosis is paramount but challenging, since it relies on non-spe-cific clinical and laboratory criteria. The latter are often altered in other diseases, including autoimmune cytopenias (AIC), which in turn can be secondary to infections, systemic autoimmune or lym-phoproliferative disorders. In the present article, we describe two patients presenting at the emer-gency department with acute AICs subsequently diagnosed as HLH with underlying diffuse large B cell lymphoma. We discuss the diagnostic challenges in the differential diagnosis of acute cytope-nias in the internal medicine setting, providing a literature review of secondary HLH and AIC.