Haemophagocytic lymphohistiocytosis in pregnancy: a pertinent case during the COVID-19 pandemic

Document Type

Article

Publication Date

9-17-2021

Publication Title

BMJ case reports

E-ISSN

1757-790X

Department(s)

Department of Obstetrics and Gynecology; Fellows and Residents

Keywords

COVID-19, haematology (incl blood transfusion), obstetrics and gynaecology

Abstract

Haemophagocytic lymphohistiocytosis (HLH) is a rare, often fatal disease, and presents a diagnostic challenge in the pregnant patient. This challenge is particularly relevant during the current COVID-19 pandemic. We present a case of HLH in a pregnant woman presenting with fever predating the COVID-19 pandemic. A 33-year-old, gravida 2, para 1 at 27 weeks' gestation presented with fever, transaminitis, thrombocytopenia and elevated ferritin. After treatment according to the HLH-94 protocol, caesarean delivery and weeks of intensive care, the patient recovered fully. With prompt diagnosis and a multispecialty team at our tertiary care facility, she and her baby overcame a dire prognosis. HLH should be considered in pregnant patients presenting with a febrile illness. Particularly in cases of severe COVID-19, secondary HLH must be considered as an associated diagnosis.

Volume

14

Issue

9

DOI

10.1136/bcr-2021-244716

PubMed ID

34535494

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