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Aguilar JJ, Dhillon V, Balasubramanian S. Manifestation of Pancytopenia Associated with COVID-19 as Paroxysmal Nocturnal Hemoglobinuria (PNH) and Aplastic Anemia (AA). Hematol Rep 2024; 16:42-49. [PMID: 38247995 PMCID: PMC10801523 DOI: 10.3390/hematolrep16010005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 12/29/2023] [Accepted: 01/10/2024] [Indexed: 01/23/2024] Open
Abstract
We report two cases of pancytopenia in patients after recovering from a mild COVID-19, now presenting as paroxysmal nocturnal hemoglobinuria (PNH) and aplastic anemia. These cases illustrate a common pathway whereby a viral trigger causes the clonal expansion of a hematological disorder. Although the association of both cases with COVID-19 is temporal and COVID-19 may be an incidental diagnosis, the growing evidence related to the hematological effects of SARS-CoV-2 infection highlights the need for further investigation into the hematological consequences of COVID-19, particularly in the post-pandemic era.
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Affiliation(s)
| | - Vikram Dhillon
- Department of Oncology, Karmanos Cancer Institute, Wayne State University, Detroit, MI 48201, USA;
| | - Suresh Balasubramanian
- Department of Oncology, Karmanos Cancer Institute, Wayne State University, Detroit, MI 48201, USA;
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Wu X, Mo Y, Wen K, Ming R, Yin X, Hu L, Liu G, Lin G, Li W. Acquired aplastic anaemia after SARS-CoV-2 infection in China: a case report. Front Pediatr 2023; 11:1277540. [PMID: 38027266 PMCID: PMC10661920 DOI: 10.3389/fped.2023.1277540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 10/25/2023] [Indexed: 12/01/2023] Open
Abstract
Since the coronavirus disease 2019 (COVID-19) pandemic began, several research groups in different countries have described cases of aplastic anaemia (AA) after COVID-19 or COVID-19 vaccination. Here, we present the case of a patient with new-onset AA in Changsha, China, that was presumably associated with preceding severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. We conducted an epidemiological assessment of the incidence rate of blood system diseases from July 1, 2022, to May 31, 2023, in the haematology department of the Second Xiangya Hospital of Central South University and Hunan Children's Hospital. The detection rates of AA and leukaemia in the first two months after the epidemic outbreak were higher than those before and during the outbreak. However, only the difference in the detection rate of leukaemia was statistically significant.
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Affiliation(s)
- Xiyan Wu
- Center for Reproductive Medicine, Hunan Provincial Maternal and Child Health Care Hospital, Changsha, China
| | - Yi Mo
- Department of Laboratory Medicine, Hunan Children’s Hospital, Changsha, China
| | - Kailiang Wen
- Medical Laboratory, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Rui Ming
- The Institute of Reproductive and Stem Cell Engineering, School of Basic Medical Science, Central South University, Changsha, China
| | - Xinyu Yin
- The Institute of Reproductive and Stem Cell Engineering, School of Basic Medical Science, Central South University, Changsha, China
| | - Liang Hu
- The Institute of Reproductive and Stem Cell Engineering, School of Basic Medical Science, Central South University, Changsha, China
| | - Gang Liu
- The Institute of Reproductive and Stem Cell Engineering, School of Basic Medical Science, Central South University, Changsha, China
| | - Ge Lin
- The Institute of Reproductive and Stem Cell Engineering, School of Basic Medical Science, Central South University, Changsha, China
| | - Weina Li
- Department of Andrology, Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha, China
- Clinical Research Center for Reproduction and Genetics in Hunan Province, Changsha, China
- Scientific Research Department, Hunan Guangxiu Hi-Tech Life Technology Co., Ltd., Changsha, China
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Yang H, Chai X, Gong Y, Zhang X, Wang L, Zhou X, Chen X, Xu J, Xu D, He G, Li J. Severe hemolytic exacerbations of Chinese PNH patients infected SARS-CoV-2 Omicron. Immun Inflamm Dis 2023; 11:e966. [PMID: 37647437 PMCID: PMC10408369 DOI: 10.1002/iid3.966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Revised: 07/17/2023] [Accepted: 07/21/2023] [Indexed: 09/01/2023] Open
Abstract
INTRODUCTION Paroxysmal nocturnal hemoglobinuria (PNH) is characterized by hemolytic anemia, bone marrow failure, thrombophilia. COVID-19, caused by a novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) with many variants including Omicron. METHODS This study collected demographic and clinical data of 20 PNH patients with SARS-CoV-2 Omicron infection. RESULTS They all were with high disease activity, and LDH level exceeded any documented since the diagnosis of PNH, and those reported in the literature for previously stable treatment with complement inhibitors. D-dimer level elevated in 10 patients. 2 patients developed mild pulmonary artery hypertension. Glomerular filtration rate declined in 5 patients. 1 patient developed acute renal failure and underwent hemodialysis. Anemia and hemolysis were improved in 5 patients treated with eculizumab. CONCLUSIONS Hemolytic exacerbation of PNH with COVID-19 is severe and eculizumab may be an effective treatment.
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Affiliation(s)
- Hui Yang
- Key Laboratory of Hematology of Nanjing Medical University, Department of HematologyCollaborative Innovation Center for Cancer Personalize, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province HospitalNanjingJiangsuChina
| | - Xingxing Chai
- Department of HematologyThe Second People's Hospital of LianyungangLianyungangJiangsuChina
| | - Yuemin Gong
- Key Laboratory of Hematology of Nanjing Medical University, Department of HematologyCollaborative Innovation Center for Cancer Personalize, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province HospitalNanjingJiangsuChina
| | - Xinyu Zhang
- Key Laboratory of Hematology of Nanjing Medical University, Department of HematologyCollaborative Innovation Center for Cancer Personalize, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province HospitalNanjingJiangsuChina
| | - Lingling Wang
- Department of HematologyWuxi People's Hospital Affiliated to Nanjing Medical UniversityWuxiJiangsuChina
| | - Xin Zhou
- Department of HematologyWuxi People's Hospital Affiliated to Nanjing Medical UniversityWuxiJiangsuChina
| | - Xiaoyu Chen
- Key Laboratory of Hematology of Nanjing Medical University, Department of HematologyCollaborative Innovation Center for Cancer Personalize, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province HospitalNanjingJiangsuChina
| | - Jinge Xu
- Department of HematologyThe Second Affiliated Hospital of Xuzhou Medical UniversityXuzhouJiangsuChina
| | - Dan Xu
- Department of HematologyFuning People's HospitalYanchengJiangsuChina
| | - Guangsheng He
- Key Laboratory of Hematology of Nanjing Medical University, Department of HematologyCollaborative Innovation Center for Cancer Personalize, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province HospitalNanjingJiangsuChina
| | - Jianyong Li
- Key Laboratory of Hematology of Nanjing Medical University, Department of HematologyCollaborative Innovation Center for Cancer Personalize, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province HospitalNanjingJiangsuChina
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