A case of hemophagocytic lymphohistiocytosis after BNT162b2 COVID-19 (Comirnaty®) vaccination.
Medicine (Baltimore)
; 101(43): e31304, 2022 Oct 28.
Статья
в английский
| MEDLINE | ID: covidwho-2135740
ABSTRACT
RATIONALE Coronavirus disease (COVID-19), an infectious disease caused by the severe acute respiratory syndrome coronavirus 2 virus, was reported in Wuhan of China in December 2019. The world is still in a state of pandemic owing to COVID-19. COVID-19 vaccines help our bodies develop immunity against the virus that causes COVID-19 without having to get the illness. Herein, we describe a rare case of a critical disorder, hemophagocytic lymphohistiocytosis (HLH), in a patient with nephritic sclerosis associated with hypertension, following mRNA COVID-19 vaccination. HLH is a life-threatening hyperinflammatory syndrome caused by aberrantly activated macrophages and cytotoxic T cells that may rapidly progress to terminal multiple organ failure. PATIENT CONCERNS An 85-year-old Japanese woman with chronic renal failure and hypertension was included in this study. Routine laboratory investigations provided the following results:
white blood cell (WBC) count, 4.6â ×â 109/L; hemoglobin (Hb), 8.1 g/dL; platelet count, 27â ×â 109/L; blood urea nitrogen 48.9 mg/dL, and serum creatinine 3.95 mg/dL. The patient developed malaise, vomiting, and persistent high fever (up to 39.7°C) on the 12th day after receiving the second dose of the vaccine. Initial evaluation revealed neutropenia. The total WBC count was 0.40â ×â 109/L (Neutrophils 0, Lymphocytes 240/µ, blast 0%); Hb 9.0 g/dL, platelet count 27â ×â 109/L; and, C Reactive Protein 9.64 mg/dL. DIAGNOSIS Further tests showed hyperferritinemia (serum ferritin 2284.4 µg/L). Bone marrow examination revealed haemophagocytosis. A provisional diagnosis of HLH associated with the Comirnaty® vaccination was made based on the HLH-2004 diagnostic criteria.INTERVENTIONS:
The patient was treated with granulocyte colony-stimulating factor and 500 mg methylprednisolone.OUTCOMES:
A significant improvement was observed in the patient's condition; the abnormal laboratory results resolved gradually, and the patient was discharged. LESSONS This case serves to create awareness among clinicians that HLH is a rare complication of COVID-19 vaccination and should be considered, especially in patients with a history of chronic renal failure and hypertension.
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Коллекция:
Международные базы данных
база данных:
MEDLINE
Основная тема:
Lymphohistiocytosis, Hemophagocytic
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COVID-19 Vaccines
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COVID-19
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Hypertension
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Kidney Failure, Chronic
Тип исследования:
История болезни
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Диагностическое исследование
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Экспериментальные исследования
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Наблюдательное исследование
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Прогностическое исследование
Темы:
Длинный Ковид
/
Вакцина
Пределы темы:
Женщины
/
Люди
Язык:
английский
Журнал:
Medicine (Baltimore)
Год:
2022
Тип:
Статья
Аффилированная страна:
MD.0000000000031304
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