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REVIEW ARTICLE
Year : 2015  |  Volume : 6  |  Issue : 1  |  Page : 1-5

Is secondary hemophagocytic lymphohistiocytosis behind the high fatality rate in Middle East respiratory syndrome corona virus?


Department of Pediatric Hematology/Oncology, King Faisal Specialist Hospital and Research Center; King Fahad Center for Children with Cancer; College of Medicine, Alfaisal University, Riyadh, Saudi Arabia

Correspondence Address:
Ali Al-Ahmari
Department of Pediatric Hematology Oncology, King Faisal Specialist Hospital and Research Center, MBC 53, P. O. Box: 3354, Riyadh 11211
Saudi Arabia
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1658-5127.155168

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Middle East respiratory syndrome corona virus (MERS-CoV) is becoming a major health concern in Saudi Arabia resulting in an associated high case fatality. The rapid deterioration of vital organs functions and high mortality rate seen in MERS-CoV has been observed previously in Epstein-Barr virus (EBV), severe acute respiratory syndrome caused by a coronavirus (SARS-CoV) and avian and bird flu-related hemophagocytic lymphohistiocytosis (HLH). There are many reports of successful treatments for severe cases of EBV-HLH using HLH-94/2004-type immunochemotherapy with etoposide as a pro-apoptotic agent. The use of immunochemotherapy in severe MERS-CoV-related HLH merits an urgent investigation in a well-designed clinical trial.


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