Ehrlichia-induced hemophagocytic lymphohistiocytosis in a pediatric kidney transplant recipient.

Creator(s)

Nisha S. Singh, Children's Mercy HospitalFollow
Alexa L. Pagano, Children's Mercy HospitalFollow
J Allyson Hays, Children's Mercy HospitalFollow
Alexander Kats, Children's Mercy HospitalFollow
Steven M. Dahl
Bradley A. Warady, Children's Mercy HospitalFollow
Nathan T. Beins, Children's Mercy HospitalFollow
Dwight E. Yin

Document Type

Article

Publication Date

2-2022

Identifier

DOI: 10.1111/petr.14134

Abstract

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.

Journal Title

Pediatric transplantation

Volume

26

Issue

1

First Page

14134

Last Page

14134

Keywords

ehrlichiosis; fever; hemophagocytic lymphohistiocytosis; kidney transplant

Recommended Citation

Singh NS, Pagano AL, Hays AJ, et al. Ehrlichia-induced hemophagocytic lymphohistiocytosis in a pediatric kidney transplant recipient. Pediatr Transplant. 2022;26(1):e14134. doi:10.1111/petr.14134