Tuberculosis presenting as dual immune dysregulation: Evans syndrome and haemophagocytic lymphohistiocytosis.
A middle-aged man with no prior health issues presented with a month-long history of fever, dry cough, weight loss, and worsening breathlessness.
Clinical pearl
Clinicians should consider disseminated tuberculosis in patients presenting with immune dysregulation syndromes, such as Evans syndrome and HLH, especially when initial treatments fail.