背景:儿童短暂性红细胞减少症(TEC)是一种获得性,自限性纯红细胞再生障碍性贫血,通常发生在4岁及以下的儿童中。先前已经描述了这种临床状况与许多病毒和免疫机制有关。由冠状病毒SARS-CoV-2引起的COVID-19于2019年12月在中国首次发现。这种疾病迅速在全世界蔓延,导致大流行。
方法:本手稿报告了与COVID-19相关的新的临床相关疾病,描述了一名儿童,其临床和生化体征为纯红细胞再生障碍,骨髓针吸取时完全没有成红细胞,有红细胞吞噬作用的迹象,类似于形态学体征,如噬血细胞淋巴组织细胞增生症(HLH),与SARS-CoV-2感染暂时相关。
结论:本报告重点介绍了新描述的SARS-CoV-2继发的免疫/血液学失调的连续实验室和临床谱。SARS-CoV-2感染相关的TEC从未在文献中描述过,但是,根据我们的发现,对于无先天性红细胞异常和与TEC相关的主要感染血清学阴性的短暂性红细胞减少症患者,应考虑。这种情况必须在相同的MIS-C谱和两种临床表现之间的相互联系中考虑,以及它们之间潜在的相互依存关系,应该在未来考虑。
BACKGROUND: Transient erythroblastopenia of childhood (TEC) is an acquired, self-limited pure red cell aplasia that usually occurs in children 4 years old and younger. This clinical condition has been priorly described to be linked to numerous viral and immunologic mechanisms. COVID-19, caused by the coronavirus SARS-CoV-2, was initially discovered in China in December 2019. The disease quickly spread worldwide, resulting in pandemic.
METHODS: This manuscript reports a new clinically relevant condition associated to COVID-19, describing a child with clinical and biochemical signs of Pure Red Blood cells aplasia and complete absence of erythroblasts at the bone marrow needle aspiration with signs of erythrophagocytosis, resembling morphological signs such as in hemophagocytic lymphohistiocytosis (HLH), temporally associated to SARS-CoV-2 infection.
CONCLUSIONS: This report highlights a newly described continuum laboratory and clinical spectrum of immune/hematological dysregulations secondary to SARS-CoV-2. SARS-CoV-2 infection-linked TEC has never been described in literature, but, according to our findings, should be considered in all the patients with transient erythroblastopenia without congenital red blood cell abnormalities and serology negative for major infections associated with TEC. This condition must be considered in the same spectrum of MIS-C and the inter-links among the two clinical manifestations, as well as a potential interdependence among them, should be considered in the future.