Protracted or recurrent COVID-19 associated cytokine storm in a patient with chronic lymphocytic leukemia receiving rituximab-based chemotherapy

Bektaş M., Özdemir G.

Clinical Immunology, cilt.236, 2022 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 236
  • Basım Tarihi: 2022
  • Doi Numarası: 10.1016/j.clim.2022.108936
  • Dergi Adı: Clinical Immunology
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, BIOSIS, CAB Abstracts, EMBASE, MEDLINE, Veterinary Science Database
  • Anahtar Kelimeler: COVID-19, Cytokine storm (hyperinflammatory syndrome), Tocilizumab, Anakinra, Rituximab, SYSTEMIC-LUPUS-ERYTHEMATOSUS, MICRORNA EXPRESSION PROFILES, RNA XIST PROMOTES, CELL-PROLIFERATION, X-CHROMOSOME, SEX-DIFFERENCES, GASTRIC-CANCER, TNF-ALPHA, B-CELLS, HEPATOCELLULAR-CARCINOMA
  • İstanbul Üniversitesi Adresli: Evet

Özet

© 2022 Elsevier Inc.A 52-year-old male patient who was diagnosed with chronic lymphocytic leukemia two years ago; admitted to our hospital with complaints of fever (>38C), shortness of breath, and fatigue. He was receiving fludarabine, cyclophosphamide, and rituximab (FCR) regimen for one year after two courses of cyclophosphamide, vincristine, and prednisolone (CVP) regimen. The patient was diagnosed with COVID-19 associated cytokine storm and tocilizumab 800 mg was administered in addition to corticosteroids. Significant improvement was observed in both clinical and laboratory parameters and his hypoxemia resolved. The patient whose complaints recurred on the 13 th day of discharge was admitted to the hospital again with severe hypoxemia (oxygen saturation < 90) and fever (>38C). Pulse steroid (250 mg methylprednisolone for three days, followed by 40 mg/day) and anakinra 400 mg/day intravenously were started. Despite the treatment, the patient progressed to respiratory failure and died on the sixth day of second hospitalization.