Hemophagocytic Lymphohistiocytosis after Lung Transplantation.
10.4266/kjccm.2015.30.1.38
- Author:
Ah Young LEEM
;
Sung Woo MOON
;
Song Yee KIM
;
Moo Suk PARK
;
Young Sam KIM
;
Se Kyu KIM
;
Joon CHANG
;
Hyo Chae PAIK
;
June Won CHEONG
;
Kyung Soo CHUNG
- Publication Type:Case Report
- Keywords:
hemophagocytic;
lung transplantation;
lymphohistiocytosis
- MeSH:
Bilirubin;
Bone Marrow;
Dexamethasone;
Diagnosis;
Etoposide;
Ferritins;
Humans;
Hyperbilirubinemia;
Interleukin-2;
L-Lactate Dehydrogenase;
Leukopenia;
Lung Transplantation*;
Lymphohistiocytosis, Hemophagocytic*;
Organ Transplantation;
Sepsis;
Splenomegaly;
Thrombocytopenia;
Transplants
- From:Korean Journal of Critical Care Medicine
2015;30(1):38-41
- CountryRepublic of Korea
- Language:English
-
Abstract:
Hemophagocytic lymphohistiocytosis (HLH) is a rare but fatal complication after solid organ transplantation. Acquired forms of HLH are described in association with severe sepsis, autoimmune disorders, malignancy, immune-compromised states, infections, and solid organ transplantation. We experienced a case of hemophagocytic lymphohistiocytosis after bilateral lung transplantation. Leukopenia, thrombocytopenia, and hyperbilirubinemia were noted and became aggravated 50 days after transplantation. Diagnosis of HLH was based on clinical and laboratory findings of splenomegaly, cytopenia, elevated ferritin, elevated interleukin-2 receptor, and hemophagocytosis in bone marrow. Other features such as elevated bilirubin, lactate dehydrogenase, and D-dimer which can be present in HLH were also noted. The patient was immediately treated with etoposide and dexamethasone. Despite aggressive therapy, the patient deteriorated and died. Awareness of the diagnostic criteria of HLH after lung transplantation is important for clinicians.
