Dear Editor, we would like to share ideas on the publication “Hemophagocytic lymphohistiocytosis (HLH) after SARS-CoV-2 vaccination [1].” Hieber et al. mentioned that “COVID-19 vaccines may occasionally trigger HLH, and Anakinra may be an efficacious treatment option for this condition [1].” The COVID-19 vaccines can cause unwanted adverse effect and HLH might be a clinical adverse effect. In the present case, the patient had HLH. However, there are no data on pre-vaccination immune/health status of this case. The HLH might or might not be an adverse effect of the COVID-19 vaccine. The possibility of a concurrent medical problem should be discussed. For example, dengue is a possible concurrent medical problem [2] and HLH might be the complication of dengue infection [3].
Author contributions
RM 50%—1a Substantial contributions to study conception and design. 1b. Substantial contributions to acquisition of data. 1c. Substantial contributions to analysis and interpretation of data. 2. Drafting the article or revising it critically for important intellectual content. 3. Final approval of the version of the article to be published. VW 50%—1a Substantial contributions to study conception and design. 1b. Substantial contributions to acquisition of data. 1c. Substantial contributions to analysis and interpretation of data. 2. Drafting the article or revising it critically for important intellectual content. 3. Final approval of the version of the article to be published.
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Declarations
Conflict of interest
The authors are from poor developing country and cannot pay for any charge and ask for full waiving for this correspondence letter. Rujittika Mungmunpuntipantip and other co-authors have no conflict of interest.
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References
- 1.Hieber ML, Sprute R, Eichenauer DA, Hallek M, Jachimowicz RD. Hemophagocytic lymphohistiocytosis after SARS-CoV-2 vaccination. Infection. 2022 doi: 10.1007/s15010-022-01786-y. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 2.Kebayoon A, Wiwanitkit V. Dengue after COVID-19 vaccination: possible and might be missed. Clin Appl Thromb Hemost. 2021;27:10760296211047229. doi: 10.1177/10760296211047229. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 3.Munshi A, Alsuraihi A, Balubaid M, Althobaiti M, Althaqafi A. Dengue-induced hemophagocytic lymphohistiocytosis: a case report and literature review. Cureus. 2021;13:e20172. doi: 10.7759/cureus.20172. [DOI] [PMC free article] [PubMed] [Google Scholar]
Associated Data
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Data Availability Statement
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