tetano
Editor, Senior Moderator
CEN Case Rep
. 2023 Mar 3.
doi: 10.1007/s13730-023-00776-9. Online ahead of print.
A case of hemophagocytic lymphohistiocytosis in a hemodialysis patient with coronavirus disease 2019
Satoru Kaneko[SUP] 1 [/SUP], Tsutomu Inoue[SUP] 1 [/SUP], Norihito Tarumoto[SUP] 2 [/SUP], Yoshiyuki Haga[SUP] 3 [/SUP], Kazuhiro Yokota[SUP] 4 [/SUP], Hiroshi Yamaguchi[SUP] 5 [/SUP], Hirokazu Okada[SUP] 6 [/SUP]
Affiliations
Abstract
During the treatment of a patient on hemodialysis with severe coronavirus disease 2019 (COVID-19), the patient was weaned from extracorporeal membrane oxygenation, which was used to treat severe COVID-19 pneumonia. However, the patient's condition worsened after the peak infection phase of COVID-19 because of acute respiratory distress syndrome with suspected hemophagocytic lymphohistiocytosis (HLH). After a bone marrow biopsy confirmed the diagnosis, methylprednisolone pulse therapy, followed by combination therapy (including oral prednisolone and cyclosporine) was immediately administered, and the patient survived. Because HLH can occur a month or more after the onset of COVID-19, even if the viral load is reduced to the point of being undetectable by reverse transcriptase-polymerase chain reaction, it can be considered to correspond to the "post-acute COVID-19 syndrome," which has recently been proposed. Early intervention is necessary, because HLH can be fatal. Therefore, it is important to know that HLH can occur at any stage of COVID-19 and to pay attention to the patient's progress over time, including checking the HScore.
Keywords: COVID-19; HScore; Hemophagocytic lymphohistiocytosis; Hemophagocytic syndrome.
. 2023 Mar 3.
doi: 10.1007/s13730-023-00776-9. Online ahead of print.
A case of hemophagocytic lymphohistiocytosis in a hemodialysis patient with coronavirus disease 2019
Satoru Kaneko[SUP] 1 [/SUP], Tsutomu Inoue[SUP] 1 [/SUP], Norihito Tarumoto[SUP] 2 [/SUP], Yoshiyuki Haga[SUP] 3 [/SUP], Kazuhiro Yokota[SUP] 4 [/SUP], Hiroshi Yamaguchi[SUP] 5 [/SUP], Hirokazu Okada[SUP] 6 [/SUP]
Affiliations
- PMID: 36864233
- DOI: 10.1007/s13730-023-00776-9
Abstract
During the treatment of a patient on hemodialysis with severe coronavirus disease 2019 (COVID-19), the patient was weaned from extracorporeal membrane oxygenation, which was used to treat severe COVID-19 pneumonia. However, the patient's condition worsened after the peak infection phase of COVID-19 because of acute respiratory distress syndrome with suspected hemophagocytic lymphohistiocytosis (HLH). After a bone marrow biopsy confirmed the diagnosis, methylprednisolone pulse therapy, followed by combination therapy (including oral prednisolone and cyclosporine) was immediately administered, and the patient survived. Because HLH can occur a month or more after the onset of COVID-19, even if the viral load is reduced to the point of being undetectable by reverse transcriptase-polymerase chain reaction, it can be considered to correspond to the "post-acute COVID-19 syndrome," which has recently been proposed. Early intervention is necessary, because HLH can be fatal. Therefore, it is important to know that HLH can occur at any stage of COVID-19 and to pay attention to the patient's progress over time, including checking the HScore.
Keywords: COVID-19; HScore; Hemophagocytic lymphohistiocytosis; Hemophagocytic syndrome.