Open AccessSevere pancytopenia and hemophagocytosis after HHV-8 primary infection in a renal transplant patient successfully treated with foscarnet1
Author(s) -
Mario Luppi,
Patrizia Barozzi,
Valeria Rasini,
Giovanni Riva,
Alessandro Re,
Giuseppe Rossi,
Gisella Setti,
Silvio Sandrini,
Fabio Facchetti,
Giuseppe Torelli
Publication year - 2002
Publication title -
transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.45
H-Index - 204
eISSN - 1534-6080
pISSN - 0041-1337
DOI - 10.1097/00007890-200207150-00023
Subject(s) - hemophagocytosis , cytopenia , pancytopenia , foscarnet , medicine , sarcoma , pathology , viremia , valganciclovir , transplantation , bone marrow , gastroenterology , immunology , herpesviridae , ganciclovir , viral disease , virus , human cytomegalovirus
We report the occurrence of human herpesvirus (HHV)-8 primary infection in an adult male kidney recipient. Four months after transplantation, the patient developed visceral Kaposi sarcoma, and 1 month later he presented with progressive and severe peripheral cytopenia, in the presence of a normocellular or hypercellular bone marrow (BM) with hemophagocytosis. HHV-8 was the sole pathogen detected by polymerase chain reaction either in the serum or in the BM. HHV-8 latent nuclear antigen was detected in immature progenitor cells from the BM. Immunosuppressive therapy was reduced, and the patient was treated with foscarnet for 2 weeks, leading to a dramatic normalization of blood cell counts, concomitantly with the disappearance of HHV-8 viremia. At the end of antiviral therapy, the patient received chemotherapy, and Kaposi sarcoma regressed in 2 months. Severe peripheral cytopenia may be a posttransplant complication after HHV-8 infection, for which treatment with foscarnet seems appropriate.