Open AccessCOVID-19-associated secondary hemophagocytic lymphohistiocytosis (cytokine storm syndrome)
Author(s) -
Е.I. Alexeeva,
Рустэм Фаридович Тепаев,
I.Yu. Shilkrot,
T.M. Dvoryakovskaya,
A.G. Surkov,
I.A. Kriulin
Publication year - 2021
Publication title -
vestnik rossijskoj akademii medicinskih nauk
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.122
H-Index - 15
eISSN - 2414-3545
pISSN - 0869-6047
DOI - 10.15690/vramn1410
Subject(s) - cytokine storm , hemophagocytic lymphohistiocytosis , macrophage activation syndrome , medicine , disease , intensive care medicine , immunology , covid-19 , inflammation , infectious disease (medical specialty) , pathology
In most cases, COVID-19 has a favorable outcome. However, the risk of developing critical forms of the disease, including secondary hemophagocytic lymphohistiocytosis HLH (cytokine storm syndrome), remains high. This dictates the interest in studying pathogenetic mechanisms, features of the clinical picture, laboratory and instrumental criteria for covid-19 disease. The article analyzes the causes of acute respiratory distress syndrome and multiple organ failure as manifestations of HLH. The necessity of monitoring signs of hyperinflammation (ferritin, C-reactive protein, etc., biomarkers of inflammation) and activation of thrombosis is substantiated, in order to make timely decisions about the beginning of pathogenetic therapy. However, there are limitations for routine testing of the level of Pro-inflammatory cytokines. Information about the diagnostic criteria of HLH is summarized, and the expediency of these criteria for establishing secondary HLH, which has complicated the course of COVID-19, is emphasized.