COVID-19 in Combination with HLH in a Child with Severe Aplastic Anemia

Abstract

Since December 2019, the coronavirus (COVID-19) has spread all over the world. This disease may present differently in immune-compromised persons. Some of the virus’s impacts have yet to be identified. In this case report, we report a three-year-and-three-month-old child with aplastic anemia who was concurrently infected with COVID-19 and HLH (hemophagocytic lymphohistiocytosis). She was referred to our center for further investigation of aplastic anemia with concurrent fever. Through examination due to splenomegaly, more evaluations were done. During admission, the PCR test for COVID-19 became positive, however, because of the fulfillment of the HLH criteria, she was diagnosed with this disease development. She was treated for HLH with IVIG and Dexamethasone while getting COVID-19 treatment. Following medicines and follow-up, her WBC and Hb count started to rise, aside from the PLT count. She continues to receive PLTs because of her thrombocytopenia till a suitable donor for BMT (Bone Marrow Transplant) is found. This case scenario highlights the COVID-19 concurrent complications for paying attention to underlying disease for better diagnosis and management.

Keywords: COVID-19, pediatrics, pancytopenia, aplastic anemia