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一名患有严重急性呼吸综合征冠状病毒2(SARS-CoV-2)诱导的噬血细胞性淋巴组织细胞增生症(HLH)患者的中性粒细胞减少性发热

Neutropenic Fever in a Patient With SARS-CoV-2-Induced Hemophagocytic Lymphohistiocytosis (HLH).

作者信息

Runge Elliot, Stoffel Steven, Rendo Matthew, Beeler Bradley W

机构信息

Internal Medicine, Brooke Army Medical Center, Fort Sam Houston, USA.

Hematology and Oncology, Brooke Army Medical Center, Fort Sam Houston, USA.

出版信息

Cureus. 2021 Dec 2;13(12):e20101. doi: 10.7759/cureus.20101. eCollection 2021 Dec.

Abstract

Hemophagocytic lymphohistiocytosis (HLH) is a severe systemic inflammatory syndrome that is often fatal. In the adult population, it is believed to develop secondary to immune dysregulation due to rheumatologic, infectious, malignant, and recently, immunomodulatory drugs. It has been well documented that infectious etiologies can lead to HLH however to date there is a paucity of case reports of HLH stemming from the 2019 novel coronavirus (SARS-CoV-2). Furthermore, it is well established that overlap exists between the extensive hyper-inflammatory syndromes produced from both HLH and severe COVID-19 infection. Here, we present a case of COVID-19-associated HLH with recurrent neutropenic fever in a patient with controlled follicular non-Hodgkin lymphoma who received treatment with etoposide after continued hospital admissions with refractory medical treatment.

摘要

噬血细胞性淋巴组织细胞增生症(HLH)是一种严重的全身性炎症综合征,通常会致命。在成人中,据信它继发于因风湿性、感染性、恶性以及最近的免疫调节药物导致的免疫失调。有充分的文献记载,感染性病因可导致HLH,但迄今为止,源自2019新型冠状病毒(SARS-CoV-2)的HLH病例报告很少。此外,HLH和严重的COVID-19感染所产生的广泛的过度炎症综合征之间存在重叠,这一点已得到充分证实。在此,我们报告一例COVID-19相关的HLH病例,患者为滤泡性非霍奇金淋巴瘤病情得到控制,在持续住院接受难治性药物治疗后接受依托泊苷治疗,出现复发性中性粒细胞减少性发热。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bc31/8720238/67726a0ebd83/cureus-0013-00000020101-i01.jpg

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