ArticleOxford medical case reports2026
Rapid response to high-dose Anakinra in refractory SLE-associated Haemophagocytic Lymphohistiocytosis: a case report.
Article in Oxford medical case reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Haemophagocytic Lymphohistiocytosis (HLH) causes life-threatening hyperinflammation and has conventionally been treated with glucocorticoids plus additional immunosuppression such as ciclosporin and anakinra. We describe the case of a 47-year-old female who presented to a DGH with HLH secondary to both Systemic Lupus Erythematosus (SLE) and Covid infection. Her disease relapsed despite an initial response to first-line treatment including glucocorticoids, ciclosporin, intravenous immunoglobulins (IVIG) and conventional doses of anakinra. She subsequently responded to a higher dose of anakinra, resulting in sustained remission. This case illustrates the potentially life-saving difference between conventional and higher anakinra doses in severe HLH- an observation that is consistent with other reported cases of HLH with different triggers. We argue, therefore, for high-dose anakinra to be used first-line in refractory HLH, given the high mortality of the disease, while also carefully monitoring for infections post-interleukin-1-blockade. This adds weight to the shifting national treatment paradigm in this direction.
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