Article Text

Download PDFPDF
Haemophagocytic lymphohistiocytosis in an adult with postacute COVID-19 syndrome
  1. Daniel Wiseman1,
  2. John Lin2,
  3. Jean-Pierre Routy3,4 and
  4. Gordan Samoukovic5
  1. 1Division of Internal Medicine, McGill University Health Centre, Montreal, Québec, Canada
  2. 2Infectious Diseases and Immunity in Global Health Program, Research Institute of the McGill University Health Centre, Montréal, Québec, Canada
  3. 3Research Institute of the McGill University Health Centre, Montreal, Québec, Canada
  4. 4Division of Haematology, McGill University Health Centre, Montreal, Québec, Canada
  5. 5Division of Critical Care Medicine, McGill University Health Centre, Montreal, Québec, Canada
  1. Correspondence to Dr Gordan Samoukovic; gordan.samoukovic{at}


Haemophagocytic lymphohistiocytosis (HLH) causing multiorgan failure has been reported as an acute clinical presentation of COVID-19. However, the literature surrounding HLH in the context of a postacute COVID-19 syndrome is limited. This report presents a case of a life-threatening HLH occurring 6 weeks after a pauci-symptomatic COVID-19 infection in a previously healthy adult. A bone marrow aspirate confirmed the HLH and the patient was successfully treated with dexamethasone and etoposide. To our knowledge, this is the first case of HLH occurring as a postacute COVID-19 syndrome following a pauci-symptomatic initial infection.

  • COVID-19
  • adult intensive care
  • haematology (incl blood transfusion)
  • malignant and benign haematology

This article is made freely available for use in accordance with BMJ’s website terms and conditions for the duration of the covid-19 pandemic or until otherwise determined by BMJ. You may use, download and print the article for any lawful, non-commercial purpose (including text and data mining) provided that all copyright notices and trade marks are retained.

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Contributors DW and GS devised the project and main conceptual ideas. DW reviewed the patient’s chart and wrote the manuscript under the supervision of J-PR and GS. J-PR provided the photos of the bone marrow aspirate. DW created the tables. GS, J-PR and JL provided feedback and helped shape the analysis and the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.