COVID-19-associated secondary hemophagocytic lymphohistiocytosis requiring hematopoietic cell transplant

Jacob R Greenmyer; Kirk D Wyatt; Sam Milanovich; Mira A Kohorst; Asmaa Ferdjallah

doi:10.1002/jha2.456

COVID-19-associated secondary hemophagocytic lymphohistiocytosis requiring hematopoietic cell transplant

EJHaem. 2022 May 11;3(3):1025-1028. doi: 10.1002/jha2.456. eCollection 2022 Aug.

Authors

Jacob R Greenmyer¹, Kirk D Wyatt², Sam Milanovich², Mira A Kohorst³, Asmaa Ferdjallah³

Affiliations

¹ Pediatric and Adolescent Medicine Mayo Clinic Rochester Minnesota USA.
² Pediatric Hematology and Oncology Sanford Health Fargo North Dakota USA.
³ Pediatric Hematology and Oncology Mayo Clinic Rochester Minnesota USA.

Abstract

Coronavirus disease 2019 (COVID-19) infection causes a variety of extrapulmonary complications in pediatric patients. Multisystem inflammatory syndrome and hemophagocytic lymphohistiocytosis (HLH) are related to hypercytokinemia in COVID-19 patients. HLH is a disorder of exaggerated inflammation resulting in a cytokine storm and unrestricted hemophagocytosis. HLH can be primary (familial) or secondary (acquired). Secondary HLH (sHLH) can occur in patients with rheumatologic, oncologic, or infectious diseases. The link between COVID-19 and HLH has been reported in pediatric patients. Here we report a case of a pediatric patient who developed refractory sHLH secondary to COVID-19 infection and required a hematopoietic cell transplant for the cure.

Keywords: hematology; infection; pediatrics; stem cell transplantation; thrombocytopenia.

Publication types

Case Reports