Haemophagocytic lymphohistiocytosis and liver failure-induced massive hyperferritinaemia in a male COVID-19 patient

The authors present the case of a 58-year-old man with the unique combination of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and, later on, haemophagocytic lymphohistiocytosis admitted to the intensive care unit. During his ICU stay the patient developed a variety of compl...

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Bibliographic Details
Published in:	Swiss medical weekly Vol. 151; no. 304; p. w20420
Main Authors:	Zellweger, Núria Manuela, Huber, Jan, Tsakiris, Dimitrios A, Tzankov, Alexandar, Gebhard, Caroline Eva, Siegemund, Martin
Format:	Journal Article
Language:	English
Published:	Switzerland SMW supporting association (Trägerverein Swiss Medical Weekly SMW) 18-01-2021
Subjects:	Acute Kidney Injury - blood Acute Kidney Injury - etiology Acute Kidney Injury - physiopathology Alanine Transaminase - blood COVID-19 COVID-19 - blood COVID-19 - complications COVID-19 - physiopathology COVID-19 - therapy Creatinine - blood Disease Progression Fatal Outcome ferritin haemophagocytic lymphohistiocytosis Heart Failure - etiology Heart Failure - physiopathology HLH Humans Hyperferritinaemia Hyperferritinemia - blood Hyperferritinemia - etiology liver failure Liver Failure - blood Liver Failure - etiology Liver Failure - physiopathology Lymphohistiocytosis, Hemophagocytic - etiology Lymphohistiocytosis, Hemophagocytic - physiopathology Male Middle Aged Multiple Organ Failure - etiology Multiple Organ Failure - physiopathology Pulmonary Embolism - etiology Pulmonary Embolism - physiopathology Respiratory Distress Syndrome - etiology Respiratory Distress Syndrome - physiopathology Respiratory Distress Syndrome - therapy SARS-CoV-2
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Summary:	The authors present the case of a 58-year-old man with the unique combination of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and, later on, haemophagocytic lymphohistiocytosis admitted to the intensive care unit. During his ICU stay the patient developed a variety of complications including acute respiratory distress syndrome, pulmonary embolism, right heart failure and suspected HLH leading to multiorgan failure and death. Despite the proven diagnosis of haemophagocytic lymphohistiocytosis, the excessively high ferritin levels of the patient did not seem fully explained by this diagnosis. Therefore, the authors want to highlight different causes of hyperferritinaemia in critically ill patients and underline the importance of differential diagnoses when interpreting continuously rising ferritin levels.
Bibliography:	ObjectType-Case Study-2 SourceType-Scholarly Journals-1 ObjectType-Feature-4 content type line 23 ObjectType-Report-1 ObjectType-Article-3
ISSN:	1424-3997 1424-3997
DOI:	10.4414/smw.2021.20420