Autoimmune hemolytic anemia: An unusual presentation of hemophagocytic lymphohistiocytosis in a pediatric post–liver transplant patient

Lauren Jarchin, Jaime Chu, Megan Januska, Pamela Merola, Ronen Arnon

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3 Scopus citations

Abstract

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.

Original languageEnglish
Article numbere13281
JournalPediatric Transplantation
Volume22
Issue number7
DOIs
StatePublished - Nov 2018

Keywords

  • autoimmune hemolytic anemia
  • hemophagocytic lymphohistiocytosis (HLH)
  • living donor liver transplant
  • pediatric liver transplantation
  • solid organ transplant

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