A Hemophagocytic Lymphohistiocytosis Patient that Presented with Unilateral Panuveitis.

PURPOSE: To describe a case of hemophagocytic lymphohistiocytosis (HLH) with ocular changes prior to the systemic changes.

METHODS

A 53-year-old man presented with the chief complaint of decreased vision in his right eye. The patient was examined by ocular examination, slit lamp examination, optical coherence tomography, laboratory examination, abdominal ultrasound, and bone marrow biopsy.

RESULTS

Ocular examination revealed uveitis OD and optical coherence tomography revealed macular edema OD. Laboratory examination demonstrated cytopenia in two cell lines, hypofibrinogenemia, and elevated serum ferritin. Abdominal ultrasound findings indicated hepatosplenomegaly. The bone marrow biopsy specimen demonstrated histiocytes and significant hemophagocytosis, leading to a diagnosis of HLH.

CONCLUSION

Ophthalmic manifestation can be the first sign of HLH and progress to fatal systemic changes.