Table 1.

Differential diagnosis of fever with gastrointestinal dysfunction during pregnancy

	HLH (in this patient)	Acute fatty liver	HELLP syndrome	Visceral leishmaniasis	Miliary/abdominal tuberculosis	Haemolytic anaemias	Chronic hepatitis	Lymphomas
Fever	Yes	Yes, rarely	No	Yes	Yes	Yes, infrequent	Yes	Yes
Abdominal pain	Yes	Yes	Yes	Yes	Yes	Yes, splenic infarct	Yes	Yes
Vomiting	Yes	Yes	Yes	Yes	Yes	No	Yes	No
Neurological symptoms	No	Yes	Yes	Yes, rarely	Yes	Yes	Yes	No
Splenomegaly	Yes	No	No	Yes	Yes	Yes	Yes	Yes
Hepatomegaly	Yes	No	No	Yes	Yes	No	No	Yes
Liver dysfunction	Yes	Yes	Yes	No	Yes, anti-tubercular medications	Yes	Yes	Yes
Coagulation abnormalities	No	Yes	Yes	No	No	No	Yes	Yes, in advanced stages
Anaemia	Yes	Yes, haemolysis	Yes, occasionally	Yes	Yes, infrequently	Yes	Yes	Yes
Thrombocytopenia	Yes	Yes	Yes	Yes	Yes, infrequently	Yes	Yes	Yes, rarely immune mediated
Leukopenia	Yes	Yes, leukocytosis	No	No	Yes, rarely, leukocytosis common	No	No	Yes, leukocytosis more common than leukopenia
High serum ferritin	Yes	No	No	No	Yes, rarely	Yes, rarely	Yes, only in advanced cirrhosis	Yes
High serum triglyceride	Yes	Yes, infrequently, mainly hypercholesterolemia	No	No	Yes, extremely rare	No	Yes, infrequently	Yes, rarely
Low serum fibrinogen	Yes	Yes	Yes	No	Yes, rarely	No	Yes	Yes, advanced stages

HLH = haemophagocytic lymphohistiocytosis; HELLP = haemolysis, elevated liver enzymes and low platelets