Case Report: Hemophagocytic lymphohistiocytosis masquerading as drug-induced liver injury: successful treatment with low-dose ruxolitinib and glucocorticoids

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Hemophagocytic lymphohistiocytosis (HLH) can present as drug-induced liver injury (DILI), complicating timely diagnosis and treatment.
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Three adult patients with DILI-like hepatic injury were treated with low-dose ruxolitinib and corticosteroids, showing rapid clinical improvement.
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All patients exhibited severe hyperbilirubinemia and cytopenias that were unresponsive to conventional therapies prior to treatment.
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Genetic testing revealed variants in immune-regulatory genes, suggesting a potential predisposition to HLH in these patients.
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The study concludes that early recognition of HLH and timely immunomodulatory therapy can significantly improve outcomes in affected patients.

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