PDF(Pubmed)
Abstract：
Hemophagocytic lymphohistiocytosis (HLH) is characterized by immune dysregulation with extensive inflammation and tissue destruction due to abnormal immune activation. Post-COVID-19 patients who have recovered with negative serologic tests may also present with secondary HLH, an unusual finding that our case demonstrates. A 73-year-old male with a notable past medical history of fall COVID-19 infection approximately 11 months prior presented initially to emergency services with a chief complaint of high fevers, lethargy, and progressive changes in mentation gradually progressive over the last 5 months\' duration. This presentation was concerning for HLH in view of the patient\'s high H score and clinical suspicion for HLH, and he was initiated on dexamethasone 20 mg daily. intravenous immune globulin (IVIG) protocol was also trialed, despite which the patient continued to deteriorate before expiring during the course of the hospitalization. sHLH following COVID-19 infection remains a poorly understood phenomenon. The severity of the COVID-19 infection does not appear to be related to one\'s predisposition to develop sHLH. The mortality of HLH remains high even with appropriate therapy.
摘要：
噬血细胞性淋巴组织细胞增生症（HLH）的特征是免疫失调，由于异常的免疫激活而导致广泛的炎症和组织破坏。血清学检查阴性的COVID-19后患者也可能出现继发性HLH，我们的案子证明了一个不寻常的发现.一名73岁男性，在大约11个月前有明显的秋季COVID-19感染病史，最初就诊于急诊服务，主要主诉为高烧，嗜睡,在过去5个月的时间里，精神的渐进变化逐渐渐进。鉴于患者的高H评分和临床怀疑HLH，本报告涉及HLH，他开始每天服用20mg地塞米松。还试验了静脉注射免疫球蛋白（IVIG）方案，尽管如此，患者在住院期间仍在呼气前继续恶化。COVID-19感染后的sHLH仍然是一个知之甚少的现象。COVID-19感染的严重程度似乎与一个人发展sHLH的易感性无关。即使采用适当的治疗，HLH的死亡率仍然很高。
