Epstein-Barr Virus Versus Novel Coronavirus-Induced Hemophagocytic Lymphohistocytosis: The Uncharted Waters. (August 2020)

• Record Type: Journal Article
• Authors: Amir, Rawan; Kichloo, Asim; Singh, Jagmeet; Bhanot, Ravinder; Aljadah, Michael; Kumar, Akshay; Albosta, Michael Stanley; Solanki, Shantanu
• Is Part Of: Journal of investigative medicine high impact case reports. Volume 8(2020)
• Publication Date: 2020-08
• Subjects: COVID-19 -- EBV -- hemophagocytic lymphohistocytosis; Internal medicine -- Periodicals; Medical care -- Periodicals; 616.005
• DOI: 10.1177/2324709620950107
• Languages: English
• ISSNs: 2324-7096

Abstract

Hemophagocytic lymphohistocytosis (HLH) is a hyperinflammatory syndrome characterized by fever, hepatosplenomegaly, and pancytopenia. It may be associated with genetic mutations or viral/bacterial infections, most commonly Epstein-Barr virus (EBV) and cytomegalovirus. As for the novel coronavirus, severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), also known as COVID-19 (coronavirus disease-2019), the cytokine storm it triggers can theoretically lead to syndromes similar to HLH. In this article, we report a case of a 28-year-old female who presented with high-grade fevers, found to have both SARS-CoV-2 and EBV infections, and eventually began to show signs of early HLH. To our knowledge, this is the first case reported in literature that raises the possibility of SARS-CoV-2–related HLH development.