Síndrome hemofagocítica secundária após transplante renal: a propósito de dois casos

Hemophagocytic syndrome or hemophagocytic lymphohistiocytosis (HLH) is an infrequent and underdiagnosed condition caused by an overactive immune response, resulting in blood cells phagocytosis. After kidney transplantation (KTx), HLH is usually secondary (or reactive) to infectious and neoplastic pr...

Descripción completa

Detalles Bibliográficos
Autores: Narciso Júnior, José, Neri, Beatriz de Oliveira, Dantas, Gilberto Loiola de Alencar, Silveira, Lara de Holanda Jucá, Sales, Maria Luiza de Mattos Brito Oliveira, Freitas, Tainá Veras de Sandes, Esmeraldo, Ronaldo de Matos
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2019
País:Brasil
Institución:Universidade Federal do Ceará (UFC)
Repositorio:Repositório Institucional da Universidade Federal do Ceará (UFC)
Idioma:inglés
OAI Identifier:oai:repositorio.ufc.br:riufc/50521
Acceso en línea:http://www.repositorio.ufc.br/handle/riufc/50521
Access Level:acceso abierto
Palabra clave:Linfo-Histiocitose Hemofagocítica
Lymphohistiocytosis, Hemophagocytic
Imunoglobulinas
Immunoglobulins
Transplante de Rim
Kidney Transplantation
Descripción
Sumario:Hemophagocytic syndrome or hemophagocytic lymphohistiocytosis (HLH) is an infrequent and underdiagnosed condition caused by an overactive immune response, resulting in blood cells phagocytosis. After kidney transplantation (KTx), HLH is usually secondary (or reactive) to infectious and neoplastic processes and has a high mortality rate. No effective treatment is available for this condition. Usual procedures include detecting and treating the pathology triggering the immune system dysregulation, other than administration of intravenous human immunoglobulin (IVIG) and high doses of steroids, and plasmapheresis. The best protocol for maintenance immunosuppressive therapy is also unknown. This article presents two cases of post-KTx reactive HLH that underwent adjuvant IVIG treatment and obtained good clinical results. Despite the high morbidity and mortality associated with reactive HLH after KTx, the early and precise diagnosis and the administration of IVIG therapy along with the treatment of the triggering disease, was an effective strategy to control HLH.