ArticleJournal of medical case reports2020
Hemophagocytic lymphohistiocytosis in a patient with COVID-19 treated with tocilizumab: a case report.
Article in Journal of medical case reports, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.
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Who cites it
18 citing papers in PubMed, 1 synthesis or guideline pooled it, 30 citations in OpenAlex.
- Hemophagocytic Lymphohistiocytosis in the adult critically ill: a narrative review of case reports and case series.Frontiers in medicine · 2025Pooled it
- Secondary hemophagocytic lymphohistiocytosis in children (Review).Experimental and therapeutic medicine · 2023Review
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- Article
- Hemophagocytic lymphohistiocytosis diagnosed by bone marrow trephine biopsy in living post-COVID-19 patients: case report and mini-review.Journal of molecular histology · 2022Review
- Hemophagocytic lymphohistiocytosis: An unusual presentation of disseminated tuberculosis: A case report and literature review.Journal of clinical tuberculosis and other mycobacterial diseases · 2022Article
- Inactivated COVID-19 vaccine triggering hemophagocytic lymphohistiocytosis in an immunocompetent adult - A case report.Journal of clinical and translational research · 2022Article
- Associations and Disease-Disease Interactions of COVID-19 with Congenital and Genetic Disorders: A Comprehensive Review.Viruses · 2022Review
- Secondary Hemophagocytic Lymphohistiocytosis in a Neonate with SARS-CoV-2 Infection.The American journal of case reports · 2022Article
- Case Report: Secondary Hemophagocytic Lymphohistiocytosis (sHLH) andFrontiers in medicine · 2022Article
- Neutropenic Fever in a Patient With SARS-CoV-2-Induced Hemophagocytic Lymphohistiocytosis (HLH).Cureus · 2021Article
- Article
- Abnormality in the NK-cell population is prolonged in severe COVID-19 patients.The Journal of allergy and clinical immunology · 2021Article
- Hemophagocytic Lymphohistiocytosis Secondary to Peripheral T Cell Lymphoma with Rapid Onset and Fatal Progression in a Young Patient: A Case Report and Review of the Literature.The American journal of case reports · 2021Review
- Hemophagocytic lymphohistiocytosis, a new cause of death during 'post-acute COVID-19 syndrome?' A case report.Journal of hematopathology · 2021Article
- Secondary Hemophagocytic Lymphohistiocytosis in Post-COVID-19 Patients: A Report of Two Cases.Cureus · 2021Article
- Complicated case of COVID-19 disease with overlapping features of thrombotic thrombocytopenic purpura and haemophagocytic lymphohistiocytosis.BMJ case reports · 2021Article
- Hemophagocytic lymphohistiocytosis: a case series analysis in a pediatric hospital.Hematology, transfusion and cell therapyArticle
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Authors and funding
5 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe understanding of coronavirus disease 2019 (COVID-19) is rapidly evolving. Although it is primarily a respiratory illness, other manifestations, such as Guillain-Barré syndrome, immune thrombocytopenia, and immune-mediated thrombotic thrombocytopenic purpura, have been described. We present a case of a patient with hemophagocytic lymphohistiocytosis secondary to COVID-19 treated with tocilizumab with a marked biochemical improvement. CASE PRESENTATION: In this case report we present a Caucasian patient with COVID-19 who developed a marked elevation of inflammatory parameters with ferritin 36,023 μg/L, but also elevated C-reactive protein 334 mg/L and lactate dehydrogenase 1074 U/L, 1 week after admission to the intensive care unit. He met five of eight criteria for hemophagocytic lymphohistiocytosis, but he lacked the high fever and cytopenia seen in the majority of cases. He was treated with tocilizumab, a monoclonal antibody targeting the interleukin-6 receptor, and over the next days, a rapid decrease in ferritin and C-reactive protein levels was observed. However, his respiratory failure only improved gradually, and he was weaned off the respirator 11 days later.
conclusionCOVID-19 may induce a hyperinflammatory clinical picture and in some cases develop into hemophagocytic lymphohistiocytosis. In our patient's case, therapeutic interleukin-6 blockade abrogated signs of hyperinflammation but did not seem to improve pulmonary function. Measurement of ferritin and C-reactive protein, as well as quantification of interleukin-6 on indication, should be performed in patients with severe COVID-19. Specific treatment in such patients must also be contemplated, preferably in randomized controlled trials.
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