Journal of Autoimmune Disorders

A Case of HaemophagocyticLymphohistocytosisand presumed COVID-19

A 20-year-old male with no previous medical history presented with a week’s history of abdominal pain, fever, diarrhoea and vomiting. Lactate was raised at 4 so a CT abdomen-pelvis was arranged which revealed hepatosplenomegaly, ascites and bilateral axillary lymphadenopathy. Ferritin was raised at 8645 on presentation but rose to >40,000 at the peak, LDH was 491, ESR 2 and CRP  90. A diagnosis of HLH was suspected and confirmed after a bone marrow aspirate which revealed haemophagocytosis of neutrophils and erythroid cells. The rest of the autoimmune, vasculitic and viral screen was negative however underlying infection was suspected due to raised CRP and low ESR. COVID-19 antigen swabs were done twice, but both came back as negative however clinically the virus was highly suspected. He received etoposide for treatment of HLH but the patient developed an acute oxygen requirement and bilateral pulmonary infiltration that was highly suspicious of COVID-19. The patient then acutely deteriorated and unfortunately died.

Author(s):

Swetha Byravan

Abstract | PDF

Share this