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KMID : 0604020150300010038
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Korean Journal of Critical Care Medicine
2015 Volume.30 No. 1 p.38 ~ p.41
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Hemophagocytic Lymphohistiocytosis after Lung Transplantation
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Leem Ah-Young
Moon Sung-Woo
Park Moo-Suk
Kim Young-Sam
Kim Se-Kyu
Chang Joon
Paik Hyo-Chae
Cheong June-Won
Chung Kyung-Soo
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Abstract
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Hemophagocytic lymphohistiocytosis (HLH) is a rare but fatal complication after solid organ transplantation. Acquired forms of HLH are described in association with severe sepsis, autoimmune disorders, malignancy, immune-compromised states, infections, and solid organ transplantation. We experienced a case of hemophagocytic lymphohistiocytosis after bilateral lung transplantation. Leukopenia, thrombocytopenia, and hyperbilirubinemia were noted and became aggravated 50 days after transplantation. Diagnosis of HLH was based on clinical and laboratory findings of splenomegaly, cytopenia, elevated ferritin, elevated interleukin-2 receptor, and hemophagocytosis in bone marrow. Other features such as elevated bilirubin, lactate dehydrogenase, and D-dimer which can be present in HLH were also noted. The patient was immediately treated with etoposide and dexamethasone. Despite aggressive therapy, the patient deteriorated and died. Awareness of the diagnostic criteria of HLH after lung transplantation is important for clinicians.
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KEYWORD
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hemophagocytic, lung transplantation, lymphohistiocytosis
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