Hemphagocytic syndrome in kidney transplant recipients: Report of four cases from a single center

GURKAN A., YAKUPOĞLU U., Yavuz A., Dikici H., Yakupoglu Y. K., Tuncer M., ...Daha Fazla

ACTA HAEMATOLOGICA, cilt.116, sa.2, ss.108-113, 2006 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 116 Sayı: 2
  • Basım Tarihi: 2006
  • Doi Numarası: 10.1159/000093640
  • Dergi Adı: ACTA HAEMATOLOGICA
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Sayfa Sayıları: ss.108-113
  • Anahtar Kelimeler: hemophagocytic syndrome, hemophagocytic syndrome,prognosis, kidney transplantation, STEM-CELL TRANSPLANTATION, REACTIVE HEMOPHAGOCYTIC SYNDROME, VERSUS-HOST-DISEASE, LIVER-TRANSPLANTATION, DIFFERENTIAL-DIAGNOSIS, HEALTHY ADULT, INFECTION, LYMPHOMA, LYMPHOHISTIOCYTOSIS, HISTIOCYTOSIS
  • Akdeniz Üniversitesi Adresli: Evet

Özet

Background. The prognosis of hemophagocytic syndrome (HPS) in kidney transplant recipients is reported to be poor, however the optimal therapeutic approach is still unclear. Patients and Methods: The clinical and follow-up data of the 4 patients with HPS (3 male, 1 female; age 39.7 +/- 11.3 years) among 368 kidney transplant recipients during a 5-year period were retrospectively analyzed. Results: HPS developed 35-61 days in the post-transplant period. All 4 patients presented with fever. Hepatosplenomegaly and lymphadenopathy were observed only in the first patient. Laboratory tests revealed pancytopenia and hyperferritinemia in all patients, but elevated liver enzymes were observed in 3. Two patients had cytomegalovirus infection, and 1 had Epstein-Barr virus infection. Three patients died despite aggressive supportive therapy, however the fourth case survived after graft nephrectomy. Conclusion: HPS pathogenesis in kidney transplants appears to be related with the graft itself. Graft nephrectomy may be the preferable therapeutic approach for kidney transplant recipients with HPS resistant to standard supportive therapy. Copyright (c) 2006 S. Karger AG, Basel.