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Autoimmune hemolytic anemia: An unusual presentation of hemophagocytic lymphohistiocytosis in a pediatric post–liver transplant patient
Author(s) -
Jarchin Lauren,
Chu Jaime,
Januska Megan,
Merola Pamela,
Ar Ronen
Publication year - 2018
Publication title -
pediatric transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.457
H-Index - 69
eISSN - 1399-3046
pISSN - 1397-3142
DOI - 10.1111/petr.13281
Subject(s) - hemophagocytic lymphohistiocytosis , medicine , autoimmune hemolytic anemia , immunosuppression , tacrolimus , immunology , hemolytic anemia , liver transplantation , hemolysis , anemia , transplantation , disease
Hemophagocytic lymphohistiocytosis ( HLH ), a rare condition characterized by immune dysfunction with uncontrolled activation of macrophages and hypersecretion of cytokines, has only been reported in a small number of pediatric patients following solid organ transplant ( SOT ). The diagnosis of HLH after SOT is especially difficult, as several of the diagnostic criteria, including fever, splenomegaly, and cytopenias, are nonspecific and can be seen with other post‐transplant complications. Autoimmune hemolytic anemia ( AIHA ) has also been reported after pediatric SOT and is thought to be related to immunosuppression, specifically tacrolimus. Although HLH and AIHA have been separately described following SOT , there have been no reports of them occurring together in post–liver transplant ( LT ) patients. We report the first case of autoimmune hemolysis as the presenting symptom of HLH in a pediatric post‐ LT patient.