Covid-19 in a patient with Familial Hemophagocytic Lymphohistiocytosis in children
Background. Based on the information obtained so far, COVID- 19 is relatively mild in children. We will present a 6-month-old male patient infected with COVID -19 in April 2020, while receiving HLH 2004 chemotherapy protocol with the diagnosis of familial (Genetic / Primary) Hemophagocytic Lymphohistiocytosis (HLH). Case. Herein we present a case accompanied by a defective perforin gene defect in the primary HLH pathogenesis, Covid-19 infection with the presence of fever and hyperferritinemia, which was evaluated in favor of reactivation and the patient was given both the HLH-2004 chemotherapy protocol treatment and COVID -19 therapy as recommended by the guidelines. Our patient improved clinically and in terms of laboratory test results at the end of the 15th day of hospitalization and was discharged. Conclusions. It should be remembered that COVID-19 can be seen with different clinical manifestations in the pediatric age group, and COVID-19 tests should be recommended, especially in children with immunosuppression and fever
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1. World Health Organization. Coronavirus disease (COVID-19) pandemic. Available at: https:// w w w . w h o . i n t / e m e r g e n c i e s / d i s e a s e s / n o ve l - coronavirus-2019 (Accessed on May 2, 2020).2. Tezer H, Bedir Demirdağ T. Novel coronavirus disease (COVID-19) in children. Turk J Med Sci 2020; 50(SI-1): 592-603. https://doi.org/10.3906/sag- 2004-174
3. Sullivan M, Bouffet E, Rodriguez-Galindo C, et al. The COVID-19 pandemic: a rapid global response for children with cancer from SIOP, COG, SIOP-E, SIOP-PODC, IPSO, PROS, CCI, and St Jude Global. Pediatr Blood Cancer 2020; 67: e28409. https://doi. org/10.1002/pbc.28409
4. Janka GE. Familial and acquired hemophagocytic lymphohistiocytosis. Annu Rev Med 2012; 63: 233-246. https://doi.org/10.1146/annurev- med-041610-134208
5. Zhu N, Zhang D, Wang W, et al; China Novel Coronavirus Investigating and Research Team. A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med 2020; 382: 727-733. https:// doi.org/10.1056/NEJMoa2001017
6. Tian S, Hu W, Niu L, Liu H, Xu H, Xiao SY. Pulmonary pathology of early-phase 2019 novel coronavirus (COVID-19) pneumonia in two patients with lung cancer. J Thorac Oncol 2020; 15: 700-704. https://doi.org/10.1016/j.jtho.2020.02.010
7. Ueda I, Morimoto A, Inaba T, et al. Characteristic perforin gene mutations of haemophagocytic lymphohistiocytosis patients in Japan. Br J Haematol 2003; 121: 503-510. https://doi.org/10.1046/j.1365- 2141.2003.0429.x
8. Filipovich AH, Chandrakasan S. Pathogenesis of hemophagocytic lymphohistiocytosis. Hematol Oncol Clin North Am 2015; 29: 895-902. https://doi. org/10.1016/j.hoc.2015.06.007
9. Bode SF, Ammann S, Al-Herz W, et al; Inborn Errors Working Party of the EBMT. The syndrome of hemophagocytic lymphohistiocytosis in primary immunodeficiencies: implications for differential diagnosis and pathogenesis. Haematologica 2015; 100: 978-988. https://doi.org/10.3324/ haematol.2014.121608
10. Fox SE, Akmatbekov A, Harbert JL, et al. Pulmonary and cardiac pathology in African American patients with COVID-19: an autopsy series from New Orleans. Lancet Respir Med 2020; 8: 681-686. https:// doi.org/10.1016/S2213-2600(20)30243-5
11. Tian S, Hu W, Niu L, Liu H, Xu H, Xiao SY. Pulmonary pathology of early-phase 2019 novel coronavirus (COVID-19) pneumonia in two patients with lung cancer. J Thorac Oncol 2020; 15: 700-704. https://doi.org/10.1016/j.jtho.2020.02.010
12. McGonagle D, Sharif K, O’Regan A, Bridgewood C. The role of cytokines including interleukin-6 in COVID-19 induced pneumonia and macrophage activation syndrome-like disease. Autoimmun Rev 2020; 19: 102537. https://doi.org/10.1016/j. autrev.2020.102537
13. Chen ZM, Fu JF, Shu Q, et al. Diagnosis and treatment recommendations for pediatric respiratory infection caused by the 2019 novel coronavirus. World J Pediatr 2020; 16: 240-246. https://doi.org/10.1007/ s12519-020-00345-5
14. Henry BM, Lippi G, Plebani M. Laboratory abnormalities in children with novel coronavirus disease 2019. Clin Chem Lab Med 2020; 58: 1135- 1138. https://doi.org/10.1515/cclm-2020-0272
15. McGonagle D, Sharif K, O’Regan A, Bridgewood C. The role of cytokines including interleukin-6 in COVID-19 induced pneumonia and macrophage activation syndrome-like disease. Autoimmun Rev 2020; 19: 102537. https://doi.org/10.1016/j. autrev.2020.102537
16. World Health Organization. Clinical management of severe acute respiratory infection when novel coronavirus (2019-nCoV) infection is suspected: interim guidance. Available at: https://apps.who.int/ iris/handle/10665/330893 (Accessed on January 28, 2020.)
17. T.C. Sağlık Bakanlığı Halk Sağlığı Genel Müdürlüğü. COVID-19 (SARS-CoV-2 Enfeksiyonu) Rehberi. Bilim Kurulu Çalışması. Ankara, 13 Nisan 2020. Available at: https://www.teb.org.tr/versions_ latest/1240/13nisansbrehberi (Accessed on April 13, 2020
- ISSN: 0041-4301
- Yayın Aralığı: Yılda 6 Sayı
- Başlangıç: 1958
- Yayıncı: Hacettepe Üniversitesi Çocuk Sağlığı Enstitüsü Müdürlüğü
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