Hemophagocytic Lymphohistiocytosis in the Setting of Disseminated Histoplasmosis and Uncontrolled HIV.

Hemophagocytic lymphohistiocytosis (HLH) is a rare and life-threateningly aggressive syndrome caused by excessive immune activation. It involves the abnormal activation of lymphocytes and macrophages which leads to tissue destruction and inflammation. Traditionally HLH classification is currently separated into primary and secondary HLH based on genetic versus nongenetic events such as infection, malignancy, or autoimmune disorders.

Opana-induced thrombotic microangiopathy masquerading as thrombotic thrombocytopenic purpura.

Opana (oxymorphone) is a powerful semi-synthetic opioid agonist used for chronic pain management that is ingested orally. However, improper injection of Opana can lead to a rare and fatal blood disorder known as thrombotic microangiopathy. Opana-induced thrombotic microangiopathy can be easily mistaken for thrombotic thrombocytopenic purpura (TTP), leading to the initiation of therapeutic plasma exchange.