학술논문

Haemophagocytic lymphohistiocytosis in kidney transplant recipients
Document Type
article
Source
Iatreia, Vol 32, Iss 4, Pp 311-320 (2019)
Subject
hemophagocytic lymphohistiocytosis
histoplasmosis
ferritins
kidney transplantation
Medicine
Medicine (General)
R5-920
Language
Spanish; Castilian
ISSN
0121-0793
2011-7965
Abstract
Hemophagocytic lymphohistiocytosis (HLH) in renal transplant recipients is a life-threatening hyper-inflammatory syndrome; associated with uncontrolled activation of cytotoxic T-lymphocytes and macrophages due to infections or immunosuppressive therapy. Histoplasmosis, tuberculosis and herpes virus infection are among the leading infectious causes. It is characterized by fever, organomegaly, cytopenia, hyperferritinemia, hypertrigiceridemia and/or hypofibrinogenemia; which may be accompanied by hemophagocytosis in bone marrow, liver or other organs. LH can follow a rapidly fatal course, with progression to multisystemic failure and death. The treatment is based on early control of the triggering cause, reducing immunosuppression and stop the inflammatory process. In some cases, is necessary to use other immunosuppressant, chemotherapy and in a very few cases, a bone marrow transplant may be required.