Open AccessMacrophage activation syndrome as an unusual presentation of paucisymptomatic severe acute respiratory syndrome coronavirus 2 infection
Author(s) -
Sanaz Lolachi,
Sarah Morin,
Matteo Coen,
Kaveh Samii,
Alexandra Calmy,
Jacques Serratrice
Publication year - 2020
Publication title -
medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.59
H-Index - 148
eISSN - 1536-5964
pISSN - 0025-7974
DOI - 10.1097/md.0000000000021570
Subject(s) - medicine , macrophage activation syndrome , hydroxychloroquine , immunology , coronavirus , cytokine release syndrome , respiratory system , disease , covid-19 , infectious disease (medical specialty) , arthritis
Rationale: Macrophage activation syndrome (MAS) is a rare life-threatening condition characterized by cytokine-mediated tissue injury and multiorgan dysfunction. Patient Concerns: We describe the unique case of young man who developed MAS as the sole manifestation of an otherwise paucisymptomatic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Diagnoses: Clinical and biological criteria led to the diagnosis of MAS; cytokine profile was highly suggestive reverse transcription polymerase chain reaction for SARS-CoV-2 in nasopharyngeal swabs was negative, but serum anti-SARS-CoV-2 immunoglobulin A and immunoglobulin G resulted positive leading to the diagnosis of SARS-CoV-2 infection. Interventions: The patient was treated with empiric antibiotic and hydroxychloroquine. Outcomes: Clinical improvement ensued. At follow-up, the patient is well. Lesson: SARS-CoV-2 infection may trigger develop life-threatening complications, like MAS. This can be independent from coronavirus disease 2019 gravity.