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COVID19 infection in a patient with paroxysmal nocturnal hemoglobinuria: A case report

INTRODUCTION: Paroxysmal nocturnal hemoglobinuria (PNH) is an acquired, life-threatening hemopoietic stem cell disorder characterized by the triad of hemolytic anemia, thrombosis, and impaired bone marrow function. Evidence suggests that severe outcomes in COVID19 infection are attributed to the exc...

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Autores principales: Sokol, Juraj, Nehaj, Frantisek, Mokan, Michal, Lisa, Lenka, Stasko, Jan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8137037/
https://www.ncbi.nlm.nih.gov/pubmed/34011023
http://dx.doi.org/10.1097/MD.0000000000025456
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author Sokol, Juraj
Nehaj, Frantisek
Mokan, Michal
Lisa, Lenka
Stasko, Jan
author_facet Sokol, Juraj
Nehaj, Frantisek
Mokan, Michal
Lisa, Lenka
Stasko, Jan
author_sort Sokol, Juraj
collection PubMed
description INTRODUCTION: Paroxysmal nocturnal hemoglobinuria (PNH) is an acquired, life-threatening hemopoietic stem cell disorder characterized by the triad of hemolytic anemia, thrombosis, and impaired bone marrow function. Evidence suggests that severe outcomes in COVID19 infection are attributed to the excessive activation of the complement cascade leading to acute lung injury and associated is with an increased prothrombotic state. PATIENT CONCERNS: A 27-year-old Caucasian man with PNH presented to the Emergency Department of our hospital with acute onset shortness of breath, cough and blood in urine. DIAGNOSIS: The patient was diagnosed with acute hemolytic exacerbation of PNH complicated with moderate COVID19 pneumonia. OUTCOMES: The patient was initiated with an anticoagulant unfractionated heparin, dexamethasone, and cefuroxime injection. His symptoms quickly resolved, and he was discharged after 5 days. CONCLUSION: The complement system activation is a critical component in the sequalae of COVID19 infection. Evidence suggests that severe outcomes in COVID19 infection are attributed to the excessive activation of the complement cascade leading to acute lung injury and associated is with an increased prothrombotic state. Notably, C5a concentration was noted to be higher in patients with COVID19 infection. The use of complement inhibitors to attenuate immune mediated damage in COVID19 nevertheless represents a very interesting theoretical approach. However, careful consideration as to which patients may benefit will be required and the outcome of clinical trials needed.
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spelling pubmed-81370372021-05-25 COVID19 infection in a patient with paroxysmal nocturnal hemoglobinuria: A case report Sokol, Juraj Nehaj, Frantisek Mokan, Michal Lisa, Lenka Stasko, Jan Medicine (Baltimore) 4800 INTRODUCTION: Paroxysmal nocturnal hemoglobinuria (PNH) is an acquired, life-threatening hemopoietic stem cell disorder characterized by the triad of hemolytic anemia, thrombosis, and impaired bone marrow function. Evidence suggests that severe outcomes in COVID19 infection are attributed to the excessive activation of the complement cascade leading to acute lung injury and associated is with an increased prothrombotic state. PATIENT CONCERNS: A 27-year-old Caucasian man with PNH presented to the Emergency Department of our hospital with acute onset shortness of breath, cough and blood in urine. DIAGNOSIS: The patient was diagnosed with acute hemolytic exacerbation of PNH complicated with moderate COVID19 pneumonia. OUTCOMES: The patient was initiated with an anticoagulant unfractionated heparin, dexamethasone, and cefuroxime injection. His symptoms quickly resolved, and he was discharged after 5 days. CONCLUSION: The complement system activation is a critical component in the sequalae of COVID19 infection. Evidence suggests that severe outcomes in COVID19 infection are attributed to the excessive activation of the complement cascade leading to acute lung injury and associated is with an increased prothrombotic state. Notably, C5a concentration was noted to be higher in patients with COVID19 infection. The use of complement inhibitors to attenuate immune mediated damage in COVID19 nevertheless represents a very interesting theoretical approach. However, careful consideration as to which patients may benefit will be required and the outcome of clinical trials needed. Lippincott Williams & Wilkins 2021-05-21 /pmc/articles/PMC8137037/ /pubmed/34011023 http://dx.doi.org/10.1097/MD.0000000000025456 Text en Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0 (https://creativecommons.org/licenses/by/4.0/) This article is made available via the PMC Open Access Subset for unrestricted re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the COVID-19 pandemic or until permissions are revoked in writing. Upon expiration of these permissions, PMC is granted a perpetual license to make this article available via PMC and Europe PMC, consistent with existing copyright protections.
spellingShingle 4800
Sokol, Juraj
Nehaj, Frantisek
Mokan, Michal
Lisa, Lenka
Stasko, Jan
COVID19 infection in a patient with paroxysmal nocturnal hemoglobinuria: A case report
title COVID19 infection in a patient with paroxysmal nocturnal hemoglobinuria: A case report
title_full COVID19 infection in a patient with paroxysmal nocturnal hemoglobinuria: A case report
title_fullStr COVID19 infection in a patient with paroxysmal nocturnal hemoglobinuria: A case report
title_full_unstemmed COVID19 infection in a patient with paroxysmal nocturnal hemoglobinuria: A case report
title_short COVID19 infection in a patient with paroxysmal nocturnal hemoglobinuria: A case report
title_sort covid19 infection in a patient with paroxysmal nocturnal hemoglobinuria: a case report
topic 4800
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8137037/
https://www.ncbi.nlm.nih.gov/pubmed/34011023
http://dx.doi.org/10.1097/MD.0000000000025456
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