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Case report
Haemophagocytic lymphohistiocytosis in pregnancy: a pertinent case during the COVID-19 pandemic
  1. Jacqueline Potts1,
  2. Brittney Gaudet2,
  3. Danielle Durie3 and
  4. Joanne Quinones3
  1. 1Obstetrics and Gynecology, Lehigh Valley Health Network, Allentown, Pennsylvania, USA
  2. 2USF Health Morsani College of Medicine, Tampa, Florida, USA
  3. 3Maternal Fetal Medicine, Lehigh Valley Health Network, Allentown, Pennsylvania, USA
  1. Correspondence to Dr Joanne Quinones; joanne_n.quinones{at}lvhn.org

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.

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

This article is made freely available for use in accordance with BMJ’s website terms and conditions for the duration of the covid-19 pandemic or until otherwise determined by BMJ. You may use, download and print the article for any lawful, non-commercial purpose (including text and data mining) provided that all copyright notices and trade marks are retained.

https://bmj.com/coronavirus/usage

https://doi.org/10.1136/bcr-2021-244716

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    Footnotes

    • Contributors JQ and DD were involved in the case that is reported here and initiated the project. JP and BG performed the literature search and drafted the paper. DD and JQ edited and revised the paper.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.