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Fatal hemophagocytic lymphohistiocytosis with intravascular large B-cell lymphoma following coronavirus disease 2019 vaccination in a patient with systemic lupus erythematosus: an intertwined case.
Ueda, Yusuke; Sakai, Tomoyuki; Yamada, Kazunori; Arita, Kotaro; Ishige, Yoko; Hoshi, Daisuke; Yanagisawa, Hiroto; Iwao-Kawanami, Haruka; Kawanami, Takafumi; Mizuta, Shuichi; Fukushima, Toshihiro; Yamada, Sohsuke; Yachie, Akihiro; Masaki, Yasufumi.
Afiliación
  • Ueda Y; Department of Hematology and Immunology, Kanazawa Medical University, Uchinada, Japan.
  • Sakai T; Department of Hematology and Immunology, Kanazawa Medical University, Uchinada, Japan.
  • Yamada K; Department of Hematology and Immunology, Kanazawa Medical University, Uchinada, Japan.
  • Arita K; Department of Medical Education, Kanazawa Medical University, Uchinada, Japan.
  • Ishige Y; Department of Hematology and Immunology, Kanazawa Medical University, Uchinada, Japan.
  • Hoshi D; Department of Respiratory Medicine, Kanazawa Medical University, Uchinada, Japan.
  • Yanagisawa H; Department of Oncologic Pathology, Kanazawa Medical University, Uchinada, Japan.
  • Iwao-Kawanami H; Department of Hematology and Immunology, Kanazawa Medical University, Uchinada, Japan.
  • Kawanami T; Department of Hematology and Immunology, Kanazawa Medical University, Uchinada, Japan.
  • Mizuta S; Department of Hematology and Immunology, Kanazawa Medical University, Uchinada, Japan.
  • Fukushima T; Department of Hematology and Immunology, Kanazawa Medical University, Uchinada, Japan.
  • Yamada S; Department of Hematology and Immunology, Kanazawa Medical University, Uchinada, Japan.
  • Yachie A; Department of Pathology and Laboratory Medicine, Kanazawa Medical University, Uchinada, Japan.
  • Masaki Y; Division of Medical Safety, Kanazawa University Hospital, Kanazawa, Japan.
Immunol Med ; 47(3): 192-199, 2024 Sep.
Article en En | MEDLINE | ID: mdl-38619098
ABSTRACT
Hemophagocytic lymphohistiocytosis (HLH) has been recognized as a rare adverse event following the coronavirus disease 2019 (COVID-19) vaccination. We report a case of neuropsychiatric symptoms and refractory HLH in a woman with systemic lupus erythematosus (SLE) after receiving her COVID-19 vaccine treated with belimumab, later found to have intravascular large B-cell lymphoma (IVLBCL) at autopsy. A 61-year-old woman with SLE was referred to our hospital because of impaired consciousness and fever. One month prior to consulting, she received her second COVID-19 vaccine dose. Afterward, her consciousness level decreased, and she developed a high fever. She tested negative for SARS-CoV-2. Neuropsychiatric SLE was suspected; therefore, glucocorticoid pulse therapy was initiated on day 1 and 8. She had thrombocytopenia, increased serum ferritin levels and hemophagocytosis. The patient was diagnosed with HLH and treated with etoposide, dexamethasone and cyclosporine. Despite treatment, the patient died on day 75; autopsy report findings suggested IVLBCL as the underlying cause of HLH. Differentiating comorbid conditions remains difficult; however, in the case of an atypical clinical presentation, other causes should be considered. Therefore, we speculate that the COVID-19 vaccination and her autoimmune condition may have expedited IVLBCL development.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Linfoma de Células B Grandes Difuso / Linfohistiocitosis Hemofagocítica / Vacunas contra la COVID-19 / SARS-CoV-2 / COVID-19 / Lupus Eritematoso Sistémico Límite: Female / Humans / Middle aged Idioma: En Revista: Immunol Med Año: 2024 Tipo del documento: Article País de afiliación: Japón Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
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XML
PubMed Links
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Linfoma de Células B Grandes Difuso / Linfohistiocitosis Hemofagocítica / Vacunas contra la COVID-19 / SARS-CoV-2 / COVID-19 / Lupus Eritematoso Sistémico Límite: Female / Humans / Middle aged Idioma: En Revista: Immunol Med Año: 2024 Tipo del documento: Article País de afiliación: Japón Pais de publicación: Reino Unido