Department of Internal Medicine and Onco-Haematology Policlinico S.Marco, GSD University and Research Hospital, Corso Europa 7, 24040, Zingonia, BG, Italy.
BMC Infect Dis. 2021 Aug 13;21(1):811. doi: 10.1186/s12879-021-06532-7.
Hemophagocytic syndrome (HPS) is a severe hyperinflammatory disease, whose diagnosis is based on the HLH-2004 criteria. In secondary forms of HLH (sHLH), the primary goal is treating the triggering factors such as COVID-19 (Coronavirus disease 2019). The link between the cytokine storm related to COVID-19 and development of sHLH has already been reported since the onset of pandemic, but little is known about clinical manifestations of HLH which develop after the patient's recovery from mild symptomatic or asymptomatic Sars-CoV-2 infection.
We describe the case of a woman diagnosed with sHLH related to previous Sars-CoV-2 infection and successfully treated with steroids, colchicine, etoposide and ruxolitinib.
Our report suggests that HLH-like syndrome might be secondary to Sars-CoV-2 infection, even if the patient utterly recovered from the mildly symptomatic viral infection. In addition, we underline the treatment with low dose ruxolitinib plus etoposide as a potential choice for Sars-CoV-2 infection related HLH.
噬血细胞综合征（HPS）是一种严重的炎症过度活跃疾病，其诊断基于 HLH-2004 标准。在继发性噬血细胞综合征（sHLH）中，主要目标是治疗触发因素，如 COVID-19（2019 年冠状病毒病）。自大流行开始以来，已经有报道称 COVID-19 相关细胞因子风暴与 sHLH 的发展之间存在联系，但对于在轻度有症状或无症状 SARS-CoV-2 感染后发展的 HLH 的临床表现知之甚少。
我们描述了一例与先前 SARS-CoV-2 感染相关的 sHLH 患者的病例，该患者成功接受了类固醇、秋水仙碱、依托泊苷和芦可替尼治疗。
我们的报告表明，即使患者从轻度有症状的病毒感染中完全康复，HLH 样综合征也可能继发于 SARS-CoV-2 感染。此外，我们强调了低剂量芦可替尼联合依托泊苷治疗 SARS-CoV-2 感染相关 HLH 的潜在选择。
