{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T13:54:36Z","timestamp":1791381276417,"version":"4.3.3"},"reference-count":18,"publisher":"BMJ","issue":"10","license":[{"start":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T00:00:00Z","timestamp":1791331200000},"content-version":"unspecified","delay-in-days":6,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2026,9,16]]},"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:p>\n                    A previously healthy woman in her early 30s developed rash, fever and arthralgia 3\u2009weeks after SARS-CoV-2 infection, rapidly progressing to multiorgan failure. Laboratory studies revealed severe thrombocytopenia (23\u00d710\n                    <jats:sup>9<\/jats:sup>\n                    \/L), microangiopathic haemolytic anaemia, acute kidney injury and ferritin &gt;100\u2009000\u2009ng\/mL. Kidney biopsy demonstrated thrombotic microangiopathy with negative antinuclear antibody, supporting atypical haemolytic uraemic syndrome (aHUS). Concurrently, low haptoglobin, elevated lactate dehydrogenase (2500 U\/L), interleukin-2 receptor (18\u2009644), triglycerides (425 mg\/dL) and splenomegaly supported haemophagocytic lymphohistiocytosis (HLH). Despite plasmapheresis, corticosteroids, etoposide, eculizumab and continuous renal replacement therapy, she died 7\u2009weeks after SARS-CoV-2 infection. Autopsy confirmed aHUS with extensive thrombotic microangiopathy and HLH with bone marrow haemophagocytosis. This case underscores the importance of recognising concurrent aHUS and HLH after COVID-19, as complement-mediated injury and hyperinflammation may produce catastrophic outcomes.\n                  <\/jats:p>","DOI":"10.1136\/bcr-2025-271520","type":"journal-article","created":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T13:15:23Z","timestamp":1791378923000},"page":"e271520","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Fatal haemophagocytic lymphohistiocytosis and atypical haemolytic uraemic syndrome following coronavirus disease 2019 infection"],"prefix":"10.1136","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-5964-7655","authenticated-orcid":false,"given":"Jennifer","family":"Khong","sequence":"first","affiliation":[{"name":"Banner Desert Medical Center, Mesa, Arizona, USA"},{"name":"Internal Medicine, The University of Arizona, Phoenix, Arizona, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alisa","family":"Liberman","sequence":"additional","affiliation":[{"name":"Banner Desert Medical Center, Mesa, Arizona, USA"},{"name":"Internal Medicine, The University of Arizona, Phoenix, Arizona, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arabella","family":"Hammoudeh","sequence":"additional","affiliation":[{"name":"Pathology, The University of Arizona Health Sciences, Tucson, Arizona, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7300-3251","authenticated-orcid":false,"given":"Karthik","family":"Kailasam","sequence":"additional","affiliation":[{"name":"Banner Desert Medical Center, Mesa, Arizona, USA"},{"name":"Internal Medicine, The University of Arizona, Phoenix, Arizona, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,10,7]]},"reference":[{"key":"2026100706151654000_19.10.e271520.1","doi-asserted-by":"crossref","first-page":"183","DOI":"10.2147\/IJNRD.S215370","article-title":"Optimal management of atypical hemolytic uremic disease: challenges and solutions","volume":"12","author":"Raina","year":"2019","journal-title":"Int J Nephrol Renovasc Dis"},{"key":"2026100706151654000_19.10.e271520.2","first-page":"e62590","article-title":"A Rare Case of Atypical Hemolytic Uremic Syndrome (HUS) in an Adult Male: A Catastrophic Presentation","volume":"6","author":"Pokhriyal","year":"2024","journal-title":"Cureus"},{"key":"2026100706151654000_19.10.e271520.3","doi-asserted-by":"crossref","first-page":"2709","DOI":"10.1016\/j.ekir.2021.07.004","article-title":"Atypical Hemolytic and Uremic Syndrome Triggered by Infection With SARS-CoV2","volume":"6","author":"Kaufeld","year":"2021","journal-title":"Kidney Int Rep"},{"key":"2026100706151654000_19.10.e271520.4","unstructured":"Konkol S . 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