Human immunodeficiency virus Associated with Haemophagocytic Syndrome in Pregnancy: A Case Report

BACKGROUND: Haemophagocytic syndrome (HPS) is a rare condition that has been documented in association with viral, bacterial, fungal and parasitic infections as well as a wide spectrum of malignant neoplasms and autoimmune diseases. Whereas HPS is a known cause of anaemia in HIV infection, its occurrence is uncommon. Its occurrence in pregnancy is even rarer and very few such cases have been reported. METHODS: Full clinical evaluation and investigations including bone marrow aspiration cytology were done to elucidate the cause of the anaemia. RESULTS: Evaluation revealed severe anaemia, increased serum bilirubin HIV positivity and a low CD4 count. The final diagnosis confirmed the case to be haemophagocytic syndrome in pregnancy. A 31-year- old primigravida presented at 21 weeks of gestation with a two-week history of fever, jaundice and abdominal pain. She responded to treatment. CONCLUSION: Although a rare condition, this case highlights the importance of a high index of suspicion for the syndrome in HIV positive pregnant women with persistent Coombs negative haemolytic anaemia. Full recovery could be expected following prompt institution of HAART and delivery.