Autoimmune hemolytic anemia and idiopathic thrombocytopenic purpura in pediatric solid organ transplant recipients, report of five cases and review of the literature

Tamir Miloh, Ronen Arnon, Elizabeth Roman, Anne Hurlet, Nanda Kerkar, Birte Wistinghausen

Research output: Contribution to journalArticlepeer-review

26 Scopus citations

Abstract

Cytopenias are common among pediatric SOT; however, autoimmune cytopenias are infrequently reported. We report five cases of autoimmune cytopenias in pediatric LT patients: two with isolated IgG-mediated AIHA, two with ITP, and one with Evans syndrome (ITP and AIHA). All patients were maintained on tacrolimus as immunosuppression. Viral illness commonly preceded the autoimmune cytopenias. All patients responded well to medical therapy (steroids, intravenous immunoglobulin, and rituximab) and lowering tacrolimus serum level. Prognosis appears to be worse when more than one cell line (e.g., Evans syndrome) is affected, and/or there is no preceding viral illness. A critical literature review of autoimmune cytopenias in children following SOT is conducted. Autoimmune cytopenias are a rarely reported complication of pediatric SOT, but clinicians taking care of pediatric transplant recipients need to be aware of this complication.

Original languageEnglish
Pages (from-to)870-878
Number of pages9
JournalPediatric Transplantation
Volume15
Issue number8
DOIs
StatePublished - Dec 2011

Keywords

  • Evans syndrome
  • autoimmune hemolytic anemia
  • idiopathic thrombocytopenic purpura
  • pediatric liver transplant
  • rituximab
  • solid organ transplant
  • tacrolimus

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