tetano
Editor, Senior Moderator
Cureus
. 2021 Dec 2;13(12):e20101.
doi: 10.7759/cureus.20101. eCollection 2021 Dec.
Neutropenic Fever in a Patient With SARS-CoV-2-Induced Hemophagocytic Lymphohistiocytosis (HLH)
Elliot Runge[SUP] 1 [/SUP], Steven Stoffel[SUP] 1 [/SUP], Matthew Rendo[SUP] 2 [/SUP], Bradley W Beeler[SUP] 2 [/SUP]
Affiliations
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.
Keywords: covid-19; cytokine release storm; hemophagocytic lymphohistiocytosis (hlh); neutropenic fever; non hodgkin's lymphoma.
. 2021 Dec 2;13(12):e20101.
doi: 10.7759/cureus.20101. eCollection 2021 Dec.
Neutropenic Fever in a Patient With SARS-CoV-2-Induced Hemophagocytic Lymphohistiocytosis (HLH)
Elliot Runge[SUP] 1 [/SUP], Steven Stoffel[SUP] 1 [/SUP], Matthew Rendo[SUP] 2 [/SUP], Bradley W Beeler[SUP] 2 [/SUP]
Affiliations
- PMID: 34993040
- PMCID: PMC8720238
- DOI: 10.7759/cureus.20101
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.
Keywords: covid-19; cytokine release storm; hemophagocytic lymphohistiocytosis (hlh); neutropenic fever; non hodgkin's lymphoma.