Ehrlichia‐induced hemophagocytic lymphohistiocytosis in a pediatric kidney transplant recipient

Background Kidney transplant patients are susceptible to a variety of infections in the post‐transplant period due to the use of immunosuppressant medications. Ehrlichiosis is a rare infection in solid organ transplant recipients with signs and symptoms that mimic rejection and other viral infection...

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Bibliographic Details
Published in:Pediatric transplantation 2022-02, Vol.26 (1), p.e14134-n/a
Main Authors: Singh, Nisha S., Pagano, Alexa L., Hays, Allyson J., Kats, Alexander, Dahl, Steven M., Warady, Bradley A., Beins, Nathan T., Yin, Dwight E.
Format: Article
Language:English
Subjects:
Adolescent
Corticosteroids
Diagnosis, Differential
Doxycycline
Ehrlichiosis
Ehrlichiosis - diagnosis
Ehrlichiosis - etiology
Ehrlichiosis - physiopathology
fever
Fever - etiology
Graft rejection
hemophagocytic lymphohistiocytosis
Histiocytosis
Humans
Immunoglobulins
Immunosuppressive agents
Infections
Intravenous administration
kidney transplant
Kidney Transplantation
Kidney transplants
Lymphatic diseases
Lymphocytosis
Lymphohistiocytosis, Hemophagocytic - diagnosis
Lymphohistiocytosis, Hemophagocytic - etiology
Male
Patients
Pediatrics
Postoperative Complications - diagnosis
Postoperative Complications - etiology
Postoperative Complications - physiopathology
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Summary:Background Kidney transplant patients are susceptible to a variety of infections in the post‐transplant period due to the use of immunosuppressant medications. Ehrlichiosis is a rare infection in solid organ transplant recipients with signs and symptoms that mimic rejection and other viral infections. Hemophagocytic lymphohistiocytosis (HLH) is a potentially fatal hyperinflammatory syndrome that can be triggered by infections. Methods We describe a pediatric kidney transplant recipient who experienced secondary HLH due to ehrlichiosis within the initial post‐transplant month. Result Our patient improved after treatment with doxycycline, corticosteroids, and intravenous immunoglobulin (IVIG). Conclusion Clinicians should consider infections such as ehrlichiosis as a potential cause of illness in febrile solid organ transplant recipients in immediate post‐transplant period, especially when accompanied by a compatible exposure history.
ISSN:1397-3142
1399-3046
DOI:10.1111/petr.14134