Hemophagocytic lymphohistiocytosis after SARS-CoV-2 vaccination.
Adrenal Cortex Hormones
Adult
COVID-19
/ prevention & control
COVID-19 Vaccines
/ adverse effects
Dexamethasone
/ therapeutic use
Etoposide
Female
Ferritins
Humans
Immunoglobulins, Intravenous
Interleukin 1 Receptor Antagonist Protein
Lymphohistiocytosis, Hemophagocytic
/ diagnosis
RNA, Messenger
Receptors, Interleukin-1
SARS-CoV-2
Vaccination
Young Adult
Hyperferritinemia
Hyperinflammation
Kineret
Lymphadenopathy
Macrophage activation syndrome
SARS-CoV-2 vaccine
Journal
Infection
ISSN: 1439-0973
Titre abrégé: Infection
Pays: Germany
ID NLM: 0365307
Informations de publication
Date de publication:
Oct 2022
Oct 2022
Historique:
received:
27
01
2022
accepted:
15
02
2022
pubmed:
27
2
2022
medline:
4
10
2022
entrez:
26
2
2022
Statut:
ppublish
Résumé
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. 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. 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. COVID-19 vaccines may occasionally trigger HLH, and Anakinra may be an efficacious treatment option for this condition.
Identifiants
pubmed: 35218512
doi: 10.1007/s15010-022-01786-y
pii: 10.1007/s15010-022-01786-y
pmc: PMC8881936
doi:
Substances chimiques
Adrenal Cortex Hormones
0
COVID-19 Vaccines
0
Immunoglobulins, Intravenous
0
Interleukin 1 Receptor Antagonist Protein
0
RNA, Messenger
0
Receptors, Interleukin-1
0
Etoposide
6PLQ3CP4P3
Dexamethasone
7S5I7G3JQL
Ferritins
9007-73-2
Types de publication
Case Reports
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1399-1404Commentaires et corrections
Type : CommentIn
Type : CommentIn
Informations de copyright
© 2022. The Author(s).
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