While I was on Heme Onc, I was sent to see a 26-year-old male with concern for HLH. This patient had virtually no past medical history and had arrived at the ED with some non-specific complaints like subjective fever, nausea, diarrhea, and muscle aches. At that time, he was entirely alert and oriented. He had a low-grade fever and a white count. Within 24 hours, he had multi-organ system failure. His lungs went first, and he had to be intubated. His LFTs soared to the 11,000s, his kidneys failed and he had to be on CVVHD, and he had troponin leaks too. Heme onc was consulted because, given the acute nature of his decompensation, the ICU team was worried about HLH (hemophagocytic lymphohistiocytosis). We sent out a soluble CD25, and ultimately we determined that he did NOT have HLH.
The ICU team was at a loss. This poor patient had multi-organ system failure of unknown origin. No one had any idea why he had decompensated so quickly. Within a few days, he, unfortunately, passed away. That was the first time I had witnessed someone in my own age group pass away. It truly made me realize how short life can be. Granted, this patient’s case may have been super rare, but it’s always saddening when someone very young passes away–they had so much to live for.
Make sure to appreciate the supportive people in your life, and thank them for being there for you. You never know when things can go south.