Medicine (Baltimore) . Macrophage activation syndrome as an unusual presentation of paucisymptomatic severe acute respiratory syndrome coronavirus 2 infection: A case report

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Medicine (Baltimore)


. 2020 Aug 7;99(32):e21570.
doi: 10.1097/MD.0000000000021570.
Macrophage activation syndrome as an unusual presentation of paucisymptomatic severe acute respiratory syndrome coronavirus 2 infection: A case report


Sanaz Lolachi ¹ , Sarah Morin ² , Matteo Coen ^{1 3} , Kaveh Samii ² , Alexandra Calmy ⁴ , Jacques Serratrice ¹



Affiliations

• PMID: 32769902
• DOI: 10.1097/MD.0000000000021570

Abstract

Rationale: Macrophage activation syndrome (MAS) is a rare life-threatening condition characterized by cytokine-mediated tissue injury and multiorgan dysfunction.
Patient concerns: We describe the unique case of young man who developed MAS as the sole manifestation of an otherwise paucisymptomatic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection.
Diagnoses: Clinical and biological criteria led to the diagnosis of MAS; cytokine profile was highly suggestive reverse transcription polymerase chain reaction for SARS-CoV-2 in nasopharyngeal swabs was negative, but serum anti-SARS-CoV-2 immunoglobulin A and immunoglobulin G resulted positive leading to the diagnosis of SARS-CoV-2 infection.
Interventions: The patient was treated with empiric antibiotic and hydroxychloroquine.
Outcomes: Clinical improvement ensued. At follow-up, the patient is well.
Lesson: SARS-CoV-2 infection may trigger develop life-threatening complications, like MAS. This can be independent from coronavirus disease 2019 gravity.