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논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 발행연도
- 2021.1
- 수록면
- 274 - 277 (4page)
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Hemophagocytic syndrome (HPS) is a rare but potentially life-threatening disease in kidney transplant recipients, and is caused by systemic proliferation of macrophages actively phagocytizing other blood cells in the bone marrow, lymph nodes, and the spleen. Here, we report a 40-year-old male kidney transplant recipient who presented with fever, bicytopenia, and elevated liver enzymes 2 months after transplantation. Given that cytomegalovirus antigenemia and real-time polymerase chain reaction tests were positive, liver biopsy was performed under an assumption of cytomegalovirus-induced hepatitis. Hepatic histology revealed multifocal microabscess with cytomegalovirus inclusion bodies, marked Kupffer cell hyperplasia, and erythrophagocytosis by activated macrophages. As laboratory findings such as hyperferritinemia, elevated serum lactate dehydrogenase, low natural killer cell activity, and high soluble interleukin-2 receptor were also compatible with HPS, the recipient was diagnosed as having cytomegalovirus-induced hepatitis combined with reactive HPS. Following intravenous ganciclovir therapy with continuous administration of tacrolimus and corticosteroid, the symptoms resolved and laboratory findings were normalized. As far as we know, this is the first report of cytomegalovirus-induced hepatitis combined with reactive HPS in a kidney transplant recipient that is diagnosed by liver biopsy.
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참고문헌 (16)
참고문헌 신청
Ponticelli C / 2009 / Haemophagocytic syndrome--a lifethreatening complication of renal transplantation / Nephrol Dial Transplant 24:2623~2627
Ardalan MR / 2008 / Postrenal transplant hemophagocytic lymphohistiocytosis and thrombotic microangiopathy associated with parvovirus b19 infection / Am J Transplant 8:1340~1344
Ramos-Casals M / 2014 / Adult haemophagocytic syndrome / Lancet 383:1503~1516
Karras A / 2004 / Hemophagocytic syndrome in renal transplant recipients: report of 17 cases and review of literature / Transplantation 77:238~243
Henter JI / 2007 / HLH-2004 : diagnostic and therapeutic guidelines for hemophagocytic lymphohistiocytosis / Pediatr Blood Cancer 48:124~131
Ardalan MR / 2008 / Postrenal transplant hemophagocytic lymphohistiocytosis and thrombotic microangiopathy associated with parvovirus b19 infection / Am J Transplant 8:1340~1344
Ramos-Casals M / 2014 / Adult haemophagocytic syndrome / Lancet 383:1503~1516
Karras A / 2004 / Hemophagocytic syndrome in renal transplant recipients: report of 17 cases and review of literature / Transplantation 77:238~243
Henter JI / 2007 / HLH-2004 : diagnostic and therapeutic guidelines for hemophagocytic lymphohistiocytosis / Pediatr Blood Cancer 48:124~131
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