Ehrlichia-induced hemophagocytic lymphohistiocytosis in a pediatric kidney transplant recipient

BACKGROUNDKidney 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...

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Bibliographic Details
Published in:Pediatric transplantation 2022, Vol.26 (1), p.e14134-e14134
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: Report
Language:English
Online Access:Get full text
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Summary:BACKGROUNDKidney 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. METHODSWe describe a pediatric kidney transplant recipient who experienced secondary HLH due to ehrlichiosis within the initial post-transplant month. RESULTOur patient improved after treatment with doxycycline, corticosteroids, and intravenous immunoglobulin (IVIG). CONCLUSIONClinicians 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:1399-3046
DOI:10.1111/petr.14134