Universität zu Köln

Hieber, Marie-Lisa, Sprute, Rosanne ORCID: 0000-0003-2457-6437, Eichenauer, Dennis A. ORCID: 0000-0002-1927-3514, Hallek, Michael ORCID: 0000-0002-7425-4455 and Jachimowicz, Ron D. (2022). Hemophagocytic lymphohistiocytosis after SARS-CoV-2 vaccination. Infection, 50 (5). S. 1399 - 1405. HEIDELBERG: SPRINGER HEIDELBERG. ISSN 1439-0973

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Abstract

Purpose The coronavirus disease 2019 (COVID-19) pandemic has led to the approval of novel vaccines with different mechanisms of action. Until now, more than 4.7 billion persons have been vaccinated around the world, and adverse effects not observed in pre-authorization trials are being reported at low frequency. Methods We report a case of severe hemophagocytic lymphohistiocytosis (HLH) after SARS-CoV-2 immunization and performed a literature search for all reported cases of COVID-19 vaccine-associated HLH. Results A 24-year-old female developed HLH after immunization with the mRNA COVID-19 vaccine Comirnaty. Diagnosis was made according to HLH-2004 criteria; the HScore was 259 (> 99% HLH probability) with maximum ferritin of 138.244 mu g/L. The patient was initially treated with intravenous immunoglobulins (IVIGs) and dexamethasone without response. The addition of the human interleukin 1 receptor antagonist Anakinra resulted in full recovery within 6 weeks after vaccination. A literature search revealed 15 additional cases of HLH after SARS-CoV-2 vaccination, the majority after immunization with Comirnaty (n = 7) or the viral vector vaccine Vaxzevria (n = 6). Treatment modalities included corticosteroids (n = 13), Anakinra (n = 5), IVIGs (n = 5), and etoposide (n = 2). Eight patients underwent combination treatment. Three of 16 patients died. Conclusion COVID-19 vaccines may occasionally trigger HLH, and Anakinra may be an efficacious treatment option for this condition.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Hieber, Marie-Lisa UNSPECIFIED UNSPECIFIED UNSPECIFIED Sprute, Rosanne UNSPECIFIED orcid.org/0000-0003-2457-6437 UNSPECIFIED Eichenauer, Dennis A. UNSPECIFIED orcid.org/0000-0002-1927-3514 UNSPECIFIED Hallek, Michael UNSPECIFIED orcid.org/0000-0002-7425-4455 UNSPECIFIED Jachimowicz, Ron D. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-672108
DOI:	10.1007/s15010-022-01786-y
Journal or Publication Title:	Infection
Volume:	50
Number:	5
Page Range:	S. 1399 - 1405
Date:	2022
Publisher:	SPRINGER HEIDELBERG
Place of Publication:	HEIDELBERG
ISSN:	1439-0973
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language Infectious Diseases Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/67210