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Abstracts
P038
Poor response Hemophagocytic Lymphohistiocytosis Secondary to EBV Reactivation in a Patient with COVID-19 Infection
Introduction:
Hemophagocytic lymphohistiocytosis (HLH) is a life-threatening hyperinflammatory syndrome. Acquired HLH can be triggered by viral infections, with Epstein-Barr virus (EBV) among the most common etiologies. Here we present a case of HLH secondary to EBV in the setting of a Coronavirus Disease 2019 (COVID-19) infected patient.
Case presentation:
A 28-year-old Hispanic previously healthy man presented with two weeks of intermittent fevers, night sweats, chills, myalgias, non-productive cough, vomiting, and watery diarrhea. He immigrated 12‚Äâyears ago.
Discussion:
This case illustrates the fatal immunologic response can occur in a patient with acquired HLH secondary to EBV and COVID-19 coinfection. The identification of viral coinfection in acquired HLH cases has been increasing and its complex immune interplay is still under investigation. In HLH, macrophage dysregulation dampens the immune system through excessive cytokine production. However, as in this case, a greater immunologic response can be expected if coinfection is identified, which translates into a worsening multiorgan dysfunction and fatal outcomes compared to simply EBV-acquired HLH. Therefore, during the ongoing COVID-19 pandemic, an increased awareness and recognition of acquired HLH due to coinfection is needed.
Hemophagocytic lymphohistiocytosis (HLH) is a life-threatening hyperinflammatory syndrome. Acquired HLH can be triggered by viral infections, with Epstein-Barr virus (EBV) among the most common etiologies. Here we present a case of HLH secondary to EBV in the setting of a Coronavirus Disease 2019 (COVID-19) infected patient.
Case presentation:
A 28-year-old Hispanic previously healthy man presented with two weeks of intermittent fevers, night sweats, chills, myalgias, non-productive cough, vomiting, and watery diarrhea. He immigrated 12‚Äâyears ago.
Discussion:
This case illustrates the fatal immunologic response can occur in a patient with acquired HLH secondary to EBV and COVID-19 coinfection. The identification of viral coinfection in acquired HLH cases has been increasing and its complex immune interplay is still under investigation. In HLH, macrophage dysregulation dampens the immune system through excessive cytokine production. However, as in this case, a greater immunologic response can be expected if coinfection is identified, which translates into a worsening multiorgan dysfunction and fatal outcomes compared to simply EBV-acquired HLH. Therefore, during the ongoing COVID-19 pandemic, an increased awareness and recognition of acquired HLH due to coinfection is needed.
Publisher
John Wiley & Sons; Hoboken, USA
Source Journal
American Journal of Hematology
2022 Wiley Periodicals LLC.
