CASE REPORT |
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Year : 2021 | Volume
: 12
| Issue : 4 | Page : 227-231 |
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Hemophagocytic lymphohistiocytosis trigged by COVID-19 infection: Case report and review of the literature
Fatma Hammami1, Makram Koubaa1, Khaoula Rekik1, Hana Chaabouni1, Mourad Chaari2, Fatma Smaoui1, Mounir Ben Jemaa1
1 Department of Infectious Diseases, Hedi Chaker University Hospital, University of Sfax, Tunisia 2 Hematology Laboratory, Hedi Chaker University Hospital, University of Sfax, Sfax, Tunisia
Correspondence Address:
Dr. Fatma Hammami Department of Infectious Diseases, Hedi Chaker University Hospital, University of Sfax, Sfax Tunisia Makram Koubaa Department of Infectious Diseases, Hedi Chaker University Hospital, University of Sfax, Sfax Tunisia
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/joah.joah_116_21
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The outbreak of the novel coronavirus-19 (COVID-19) rapidly grew into a worldwide pandemic. The link between the disease severity and higher levels of inflammatory markers was reported including cases of hemophagocytic lymphohistiocytosis (HLH), a potentially life-threatening disorder. We report herein a case of HLH trigged by COVID-19 infection and we review all reported cases of HLH secondary to COVID-19 among immunocompromised patients by searching PubMed publications till July 2021. A 69-year-old woman with a previous medical history of diabetes mellitus and rheumatoid arthritis treated with oral steroids presented for a 5-day history of fever, persistent cough, anorexia, and dyspnea. The diagnosis of COVID-19 was confirmed. She received empiric antibiotic therapy, oxygen supply, and corticosteroids. On day 17, laboratory investigations revealed bicytopenia with a platelets rate of 31,000/mm3 and an hemoglobin rate of 8.2 g/dL. Hyperferritinemia, hypertriglyceridemia, and hypofibrinogenemia were noted. Bone marrow aspiration and biopsy revealed images of hemophagocytosis. The HScore yielded 200 points, representing 80%–88% probability of HLH. We continued corticosteroids and treatment. The disease evolution was favorable. The diagnosis of HLH secondary to COVID-19 shoud be considered in front of cytopenia, hyperinflammatory state, and a worsening clinical condition. Prompt diagnosis and treatment improve the prognosis.
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