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Hemophagocytic lymphohistiocytosis after SARS-CoV-2 vaccination
PURPOSE: The coronavirus disease 2019 (COVID-19) pandemic has led to the approval of novel vaccines with different mechanisms of action. Until now, more than 4.7 billion persons have been vaccinated around the world, and adverse effects not observed in pre-authorization trials are being reported at...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Berlin Heidelberg
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8881936/ https://www.ncbi.nlm.nih.gov/pubmed/35218512 http://dx.doi.org/10.1007/s15010-022-01786-y |
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author | Hieber, Marie-Lisa Sprute, Rosanne Eichenauer, Dennis A. Hallek, Michael Jachimowicz, Ron D. |
author_facet | Hieber, Marie-Lisa Sprute, Rosanne Eichenauer, Dennis A. Hallek, Michael Jachimowicz, Ron D. |
author_sort | Hieber, Marie-Lisa |
collection | PubMed |
description | PURPOSE: The coronavirus disease 2019 (COVID-19) pandemic has led to the approval of novel vaccines with different mechanisms of action. Until now, more than 4.7 billion persons have been vaccinated around the world, and adverse effects not observed in pre-authorization trials are being reported at low frequency. METHODS: We report a case of severe hemophagocytic lymphohistiocytosis (HLH) after SARS-CoV-2 immunization and performed a literature search for all reported cases of COVID-19 vaccine-associated HLH. RESULTS: A 24-year-old female developed HLH after immunization with the mRNA COVID-19 vaccine Comirnaty. Diagnosis was made according to HLH-2004 criteria; the HScore was 259 (> 99% HLH probability) with maximum ferritin of 138.244 µg/L. The patient was initially treated with intravenous immunoglobulins (IVIGs) and dexamethasone without response. The addition of the human interleukin 1 receptor antagonist Anakinra resulted in full recovery within 6 weeks after vaccination. A literature search revealed 15 additional cases of HLH after SARS-CoV-2 vaccination, the majority after immunization with Comirnaty (n = 7) or the viral vector vaccine Vaxzevria (n = 6). Treatment modalities included corticosteroids (n = 13), Anakinra (n = 5), IVIGs (n = 5), and etoposide (n = 2). Eight patients underwent combination treatment. Three of 16 patients died. CONCLUSION: COVID-19 vaccines may occasionally trigger HLH, and Anakinra may be an efficacious treatment option for this condition. |
format | Online Article Text |
id | pubmed-8881936 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Springer Berlin Heidelberg |
record_format | MEDLINE/PubMed |
spelling | pubmed-88819362022-02-28 Hemophagocytic lymphohistiocytosis after SARS-CoV-2 vaccination Hieber, Marie-Lisa Sprute, Rosanne Eichenauer, Dennis A. Hallek, Michael Jachimowicz, Ron D. Infection Case Report PURPOSE: The coronavirus disease 2019 (COVID-19) pandemic has led to the approval of novel vaccines with different mechanisms of action. Until now, more than 4.7 billion persons have been vaccinated around the world, and adverse effects not observed in pre-authorization trials are being reported at low frequency. METHODS: We report a case of severe hemophagocytic lymphohistiocytosis (HLH) after SARS-CoV-2 immunization and performed a literature search for all reported cases of COVID-19 vaccine-associated HLH. RESULTS: A 24-year-old female developed HLH after immunization with the mRNA COVID-19 vaccine Comirnaty. Diagnosis was made according to HLH-2004 criteria; the HScore was 259 (> 99% HLH probability) with maximum ferritin of 138.244 µg/L. The patient was initially treated with intravenous immunoglobulins (IVIGs) and dexamethasone without response. The addition of the human interleukin 1 receptor antagonist Anakinra resulted in full recovery within 6 weeks after vaccination. A literature search revealed 15 additional cases of HLH after SARS-CoV-2 vaccination, the majority after immunization with Comirnaty (n = 7) or the viral vector vaccine Vaxzevria (n = 6). Treatment modalities included corticosteroids (n = 13), Anakinra (n = 5), IVIGs (n = 5), and etoposide (n = 2). Eight patients underwent combination treatment. Three of 16 patients died. CONCLUSION: COVID-19 vaccines may occasionally trigger HLH, and Anakinra may be an efficacious treatment option for this condition. Springer Berlin Heidelberg 2022-02-26 2022 /pmc/articles/PMC8881936/ /pubmed/35218512 http://dx.doi.org/10.1007/s15010-022-01786-y Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Case Report Hieber, Marie-Lisa Sprute, Rosanne Eichenauer, Dennis A. Hallek, Michael Jachimowicz, Ron D. Hemophagocytic lymphohistiocytosis after SARS-CoV-2 vaccination |
title | Hemophagocytic lymphohistiocytosis after SARS-CoV-2 vaccination |
title_full | Hemophagocytic lymphohistiocytosis after SARS-CoV-2 vaccination |
title_fullStr | Hemophagocytic lymphohistiocytosis after SARS-CoV-2 vaccination |
title_full_unstemmed | Hemophagocytic lymphohistiocytosis after SARS-CoV-2 vaccination |
title_short | Hemophagocytic lymphohistiocytosis after SARS-CoV-2 vaccination |
title_sort | hemophagocytic lymphohistiocytosis after sars-cov-2 vaccination |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8881936/ https://www.ncbi.nlm.nih.gov/pubmed/35218512 http://dx.doi.org/10.1007/s15010-022-01786-y |
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