Hemophagocytic syndrome, a diagnostic challenge in Gastroenterology

Hemophagocytic lymphohistiocytosis is a syndrome of severe immune activation with macrophage and T- cell infiltration resulting in multi organ damage. We report the case of a patient successfully treated for a haemophagocytic syndrome triggered by a metastatic neoplasm of the rectum. A 57 years old man is initially presented with fever without focus. Despite of wide spectrum antibiotics he developed a multi-organ dysfunction. A bone marrow aspirate showed histiocytes that had phagocytosed hematic cells. Hemophagocytic syndrome was suspected and specific treatment was administered. The patient's condition improved remarkably and he was discharged. Nevertheles, finally, the patient died due to a bad response to chemotherapy. Malignancies are a well known triggering of hemophagocytic lymphohistiocytosis being hematological the most commun malignancy associated. However, solid tumors are anecdotic and, to our knowledge, this case is the first one documented due only to rectal carcinoma.