Secondary hemophagocytic lymphohistiocytosis and severe liver injury induced by hepatic SARS-CoV-2 infection unmasking Wilson's disease: Balancing immunosuppression.
Int J Infect Dis
; 103: 624-627, 2021 Feb.
Article
in English
| MEDLINE | ID: covidwho-1065181
ABSTRACT
A 21-year-old woman was hospitalized due to coronavirus disease 2019 (COVID-19)-associated respiratory and hepatic impairment concomitant with severe hemolytic anemia. Upon diagnosis of secondary hemophagocytic lymphohistiocytosis, immunosuppression with anakinra and steroids was started, leading to a hepatic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and viremia. Subsequent liver biopsy revealed virus particles in hepatocytes by electron microscopy and SARS-CoV-2 virus could be isolated and cultured. Immunosuppression was stopped and convalescent donor plasma given. In the differential diagnosis, an acute crisis of Wilson's disease was raised by laboratory and genetic testing. This case highlights the complexity of balancing immunosuppression to control hyperinflammation versus systemic SARS-CoV-2 dissemination.
Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Lymphohistiocytosis, Hemophagocytic
/
SARS-CoV-2
/
COVID-19
/
Hepatolenticular Degeneration
/
Liver
Type of study:
Case report
/
Diagnostic study
/
Observational study
Topics:
Long Covid
Limits:
Adult
/
Female
/
Humans
/
Young adult
Language:
English
Journal:
Int J Infect Dis
Journal subject:
Communicable Diseases
Year:
2021
Document Type:
Article
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