Tongue Necrosis as a Manifestation of Immune Dysfunction: A Complex Case of Lupus, Histoplasmosis, and Macrophage Activation SyndromeMadalyn Walsh, MD1, Alick Feng, MD2, Petar Lenart, MD PhD2, Bharat Kumar, MD MME21Department of Internal Medicine, University of Iowa Hospitals & Clinics2Division of Immunology, University of Iowa Hospitals & Clinics