A 10-month-old boy was diagnosed with X-linked lymphoproliferative syndrome type 2 due to X-linked inhibitor of apoptosis deficiency after presenting with failure to thrive and refractory inflammatory bowel disease. He underwent a matched unrelated donor stem cell transplant with reduced intensity conditioning at 16 months. At 27 months, he presented with an atypical inflammatory syndrome in the setting of recent COVID-19 infection, Epstein-Barr viremia, and low chimerism (7.3%). He recovered after treatment with intravenous immunoglobulin and steroids.
Keywords: Atypical inflammatory syndrome; COVID-19; SARS-CoV-2; X-linked inhibitor of apoptosis deficiency (XIAP); X-linked lymphoproliferative (XLP); bone marrow transplant; multisystem inflammatory syndrome in children (MIS-C); primary immunodeficiency; stem cell transplant.
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