tetano
Editor, Senior Moderator
Infect Dis (Lond)
. 2021 Dec 2;1-5.
doi: 10.1080/23744235.2021.2010801. Online ahead of print.
Patients presenting high fever with lymphadenopathy after COVID-19 vaccination were diagnosed with hemophagocytic lymphohistiocytosis
Dong Won Baek[SUP] 1 [/SUP], Soyoon Hwang[SUP] 2 [/SUP], Juhyung Kim[SUP] 1 [/SUP], Jung Min Lee[SUP] 1 [/SUP], Hee Jeong Cho[SUP] 1 [/SUP], Joon-Ho Moon[SUP] 1 [/SUP], Narae Hwang[SUP] 3 [/SUP], Ji Yun Jeong[SUP] 4 [/SUP], Sang-Woo Lee[SUP] 5 [/SUP], Sang Kyun Sohn[SUP] 1 [/SUP]
Affiliations
Abstract
Background: The coronavirus disease 2019 (COVID-19) pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is still continuing worldwide. Currently, two mRNA-based vaccines and two DNA vaccines using an adenovirus vector are representative vaccines. Since the SARS-CoV-2 vaccines began to be administered, a significant decrease in new infections and COVID-19-associated death has been reported. However, various adverse events from mild symptoms to death have also been described after vaccination.
Case description: Patients with high fever and lymphadenopathy who are diagnosed with hemophagocytic lymphohistiocytosis (HLH) after COVID-19 vaccination are very rare, and there is no standard management guideline for these patients thus far. Herein, we described two cases of HLH after the administration of an mRNA-based vaccine and adenovirus vector vaccine.
Discussion: HLH is a life-threatening hyperinflammatory syndrome that occurs due to persistent stimulation of lymphocytes and histiocytes in various underlying conditions at all ages. Although the exact mechanisms and risk factors of COVID-19 vaccination-related HLH are still unknown, vigorous immune stimulation may trigger a huge cytokine storm, rarely resulting in HLH. It is important to note that early suspicion by clinicians can lower the mortality rate.
Keywords: COVID-19; fever; hemophagocytic lymphohistiocytosis; lymphadenopathy; vaccination.
. 2021 Dec 2;1-5.
doi: 10.1080/23744235.2021.2010801. Online ahead of print.
Patients presenting high fever with lymphadenopathy after COVID-19 vaccination were diagnosed with hemophagocytic lymphohistiocytosis
Dong Won Baek[SUP] 1 [/SUP], Soyoon Hwang[SUP] 2 [/SUP], Juhyung Kim[SUP] 1 [/SUP], Jung Min Lee[SUP] 1 [/SUP], Hee Jeong Cho[SUP] 1 [/SUP], Joon-Ho Moon[SUP] 1 [/SUP], Narae Hwang[SUP] 3 [/SUP], Ji Yun Jeong[SUP] 4 [/SUP], Sang-Woo Lee[SUP] 5 [/SUP], Sang Kyun Sohn[SUP] 1 [/SUP]
Affiliations
- PMID: 34854350
- DOI: 10.1080/23744235.2021.2010801
Abstract
Background: The coronavirus disease 2019 (COVID-19) pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is still continuing worldwide. Currently, two mRNA-based vaccines and two DNA vaccines using an adenovirus vector are representative vaccines. Since the SARS-CoV-2 vaccines began to be administered, a significant decrease in new infections and COVID-19-associated death has been reported. However, various adverse events from mild symptoms to death have also been described after vaccination.
Case description: Patients with high fever and lymphadenopathy who are diagnosed with hemophagocytic lymphohistiocytosis (HLH) after COVID-19 vaccination are very rare, and there is no standard management guideline for these patients thus far. Herein, we described two cases of HLH after the administration of an mRNA-based vaccine and adenovirus vector vaccine.
Discussion: HLH is a life-threatening hyperinflammatory syndrome that occurs due to persistent stimulation of lymphocytes and histiocytes in various underlying conditions at all ages. Although the exact mechanisms and risk factors of COVID-19 vaccination-related HLH are still unknown, vigorous immune stimulation may trigger a huge cytokine storm, rarely resulting in HLH. It is important to note that early suspicion by clinicians can lower the mortality rate.
Keywords: COVID-19; fever; hemophagocytic lymphohistiocytosis; lymphadenopathy; vaccination.