Hemophagocytic lymphohistiocytosis after COVID-19 vaccination.
J Hematol Oncol
; 14(1): 87, 2021 06 04.
Article
in English
| MEDLINE | ID: covidwho-1259207
ABSTRACT
Cases of thrombotic thrombocytopenia induced by coronavirus disease 2019 (COVID-19) vaccines have been reported recently. Herein, we describe the first case of another critical disorder, hemophagocytic lymphohistiocytosis (HLH), in a healthy individual after COVID-19 vaccination. A 43-year-old Chinese farmer developed malaise, vomiting, and persistent high fever (up to 39.7 °C) shortly after receiving the first dose of the inactivated SARS-CoV-2 vaccine. The initial evaluation showed pancytopenia (neutrophil count, 0.70 × 109/L; hemoglobin, 113 g/L; platelet, 27 × 109/L), elevated triglyceride (2.43 mmol/L), and decreased fibrinogen (1.41 g/L). Further tests showed high serum ferritin levels (8140.4 µg/L), low NK cell cytotoxicity (50.13%-60.83%), and positive tests for Epstein-Barr virus (EBV) DNA. Hemophagocytosis was observed in the bone marrow. Therefore, HLH was confirmed, and dexamethasone acetate (10 mg/day) was immediately prescribed without etoposide. Signs and abnormal laboratory results resolved gradually, and the patient was discharged. HLH is a life-threatening hyperinflammatory syndrome caused by aberrantly activated macrophages and cytotoxic T cells, which may rapidly progress to terminal multiple organ failure. In this case, HLH was induced by the COVID-19 vaccination immuno-stimulation on a chronic EBV infection background. This report indicates that it is crucial to exclude the presence of active EBV infection or other common viruses before COVID-19 vaccination.
Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Lymphohistiocytosis, Hemophagocytic
/
COVID-19 Vaccines
/
COVID-19
Type of study:
Case report
/
Diagnostic study
/
Experimental Studies
/
Observational study
Topics:
Long Covid
/
Vaccines
Limits:
Adult
/
Humans
/
Male
Language:
English
Journal:
J Hematol Oncol
Journal subject:
Hematology
/
Neoplasms
Year:
2021
Document Type:
Article
Affiliation country:
S13045-021-01100-7
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