Hemophagocytic Syndrome and COVID-19: A Comprehensive Review.
| Autor: | Fadlallah MM; Department of Laboratory Medicine, Faculty of Medical Sciences, Lebanese University, Beirut, LBN., Salman SM; Department of Laboratory Medicine, Al-Zahraa Hospital University Medical Center, Beirut, LBN.; Department of Laboratory Medicine, Faculty of Medical Sciences, Lebanese University, Beirut, LBN., Fadlallah MM; Department of Pediatrics, Bahman Hospital, Beirut, LBN., Rahal H; Department of Infectious Diseases, Bahman Hospital, Beirut, LBN. |
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| Jazyk: | angličtina |
| Zdroj: | Cureus [Cureus] 2023 Mar 14; Vol. 15 (3), pp. e36140. Date of Electronic Publication: 2023 Mar 14 (Print Publication: 2023). |
| DOI: | 10.7759/cureus.36140 |
| Abstrakt: | Hemophagocytic lymphohistiocytosis (HLH), a hyperinflammatory hyperferritinemic syndrome, is triggered by various etiologies and diseases and can lead to multiorgan dysfunction and death. There are two types of HLH: primary and secondary. Primary HLH (pHLH) is caused by a genetic mutation resulting in dysfunction in cytotoxic T lymphocytes (CTLs), natural killer (NK) cells, hyperactivated immune cells, and hypercytokinemia. In secondary HLH (sHLH), an underlying etiology is the cause of the disease. Infections, malignancy, and autoimmune diseases are well-known triggers for sHLH. Infectious triggers for sHLH are most frequently viruses, where different mechanisms, including dysregulated CTLs and NK cell activity and persistent immune system stimulation, have been reported. Similarly, in severe coronavirus disease 2019 (COVID-19) patients, a hyperinflammatory mechanism leading to hypercytokinemia and hyperferritinemia has been demonstrated. A similar dysfunction in CTLs and NK cells, persistent immune system stimulation with increased cytokines production, and severe end-organ damage have been reported. Therefore, a significant overlap is present between the clinical and laboratory features seen in COVID-19 and sHLH. However, SARS-CoV-2, similar to other viruses, can trigger sHLH. Hence, a diagnostic approach is needed in severe COVID-19 patients presenting with multiorgan failure, in whom sHLH should be considered. Competing Interests: The authors have declared that no competing interests exist. (Copyright © 2023, Fadlallah et al.) |
| Databáze: | MEDLINE |
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