Neurological signs described in HLH are encephalopathy, meningism, hypotonia, hemiplegia and seizures [2, 13] . Our patient developed bilateral ptosis which eventually resolved over 2-3 weeks. Phagocytosis, reportedly, most affects the red cells and platelets, however, in our case the majority of the ingested cells were of the myeloid and lymphoid lineages [14] .