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Zhang HQ, Cao BZ, Cao QT, Hun M, Cao L, Zhao MY. An analysis of reported cases of hemophagocytic lymphohistiocytosis (HLH) after COVID-19 vaccination. Hum Vaccin Immunother 2023; 19:2263229. [PMID: 37811764 PMCID: PMC10563610 DOI: 10.1080/21645515.2023.2263229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 09/22/2023] [Indexed: 10/10/2023] Open
Abstract
Although COVID-19 vaccines are an effective public health tool to combat the global pandemic, serious adverse events, such as hemophagocytic lymphohistiocytosis (HLH), caused by them are a concern. In this systematic review, cases of HLH reported after COVID-19 vaccination have been examined to understand the relationship between the two and propose effective therapeutic strategies. Furthermore, ruxolitinib's potential as a cytokine inhibitor and its affinity for CD25 were initially assessed through molecular docking, aiming to aid targeted HLH therapy. PubMed and Web of Science databases were searched for published individual case reports on the occurrence of HLH after the administration of any COVID-19 vaccine. A total of 17 articles (25 patients) were included in this qualitative analysis. Furthermore, molecular docking was employed to investigate the therapeutic potential of ruxolitinib for HLH after COVID-19 vaccination. The mean age of patients who developed HLH after COVID-19 vaccination was 48.1 years. Most HLH episodes occurred after the BNT162b2 mRNA COVID-19 vaccination (14/25 cases) and to an extent after the ChAdOx1 nCov-19 vaccination (5/25 cases). Almost all affected patients received steroid and antibiotic therapy. Three patients died despite treatment because of esophagus rupture, neutropenic fever, bacteroides bacteremia, refractory shock, and encephalopathy and shock. Visual docking results of IL-2 Rα and ruxolitinib using the Discovery Studio 2019 Client software yielded a model score of 119.879. The findings highlight the importance of considering and identifying the adverse effects of vaccination and the possibility of using ruxolitinib for treating HLH after COVID-19 vaccination.
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Affiliation(s)
- Han-Qi Zhang
- Department of Pediatrics, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China
- Xiangya School of Medicine, Central South University, Changsha, Hunan, China
- State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Bu-Zi Cao
- Department of Pediatrics, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China
- Medical School, Hunan Normal University, Changsha, China
| | - Qing-Tai Cao
- Department of Pediatrics, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China
- Transplantation Center, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Marady Hun
- Department of Pediatrics, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Lin Cao
- Academician Workstation, Changsha Medical University, Changsha, China
- Hunan Provincial Key Laboratory of the Research and Development of Novel Pharmaceutical Preparations, Changsha Medical University, Changsha, China
| | - Ming-Yi Zhao
- Department of Pediatrics, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China
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Lu AJ, Cheng M, Dong CX, Guo HW, Cao BZ, Hu HQ. [A clinical and pathological report of delayed encephalopathy after heat stroke]. Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi 2021; 39:450-452. [PMID: 34218565 DOI: 10.3760/cma.j.cn121094-20200413-00183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To explore the clinical manifestations, dynamic neuroimaging changes and brain histopathologic characteristics of a patient with delayed encephalopathy after heat stroke. Methods: In October 2019, the clinical manifestations, electroencephalogram, cerebrospinal fluid, imaging changes and brain histopathological characteristics of a patient with brain damage caused by heat stroke were retrospectively analyzed. Results: The patient was a 40-year-old male who suddenly appeared dizziness, unconscious, high fever when working in the high temperature environment. The EEG showed diffuse slow wave activity. Early CT was normal, and abnormal signals gradually appeared in the basal ganglia region of the thalamus after a few days. In the late, the MRI found a large area of abnormal signals under the cerebral cortex, and white matter was involved. Pathological examination of brain biopsy showed that cortical neuron loss, loose white matter changes, and significant demyelination changes, while no inflammatory cell infiltration was observed in subarachnoid space, meninges, and dermal white matter. Conclusion: Imaging examination dynamic changes of the delayed encephalopathy is important in the heat stroke, and the main pathological manifestation is demyelination.
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Affiliation(s)
- A J Lu
- WeiFang Medical University, Weifang 261053, China Department of Neurology, the 960th Hospital of PLA, Jinan 250031, China
| | - M Cheng
- Department of Neurology, the 960th Hospital of PLA, Jinan 250031, China
| | - C X Dong
- Department of Neurology, the 960th Hospital of PLA, Jinan 250031, China
| | - H W Guo
- Department of Neurology, the 960th Hospital of PLA, Jinan 250031, China
| | - B Z Cao
- Department of Neurology, the 960th Hospital of PLA, Jinan 250031, China
| | - H Q Hu
- Department of Neurology, the 960th Hospital of PLA, Jinan 250031, China
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Cao BZ. [Glomus tumors of the finger]. Zhonghua Wai Ke Za Zhi 1985; 23:332-3, 380. [PMID: 2996857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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