巨细胞病毒引发肾移植受者嗜血细胞淋巴组织细胞增多症

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摘要

一名 70 多岁的妇女在接受肾移植手术四个月后出现发热、上腹不适和食欲不振。移植十天后,她出现了抗体介导的排斥反应,经过大剂量静脉注射皮质类固醇、血浆置换和利妥昔单抗治疗后,她的排斥反应得到了成功控制。两个月前,中性粒细胞减少症导致缬更昔洛韦预防性治疗中断,当时她的供体为巨细胞病毒血清反应阳性,而受体为沙眼衣原体阴性。她的免疫抑制治疗包括他克莫司、霉酚酸酯和皮质类固醇。
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Cytomegalovirus Triggering Hemophagocytic Lymphohistiocytosis in a Kidney Transplant Recipient
A woman in her 70s presented four months after receiving a kidney transplant with fever, epigastric discomfort and loss of appetite. She had experienced antibody-mediated rejection ten days after transplantation, successfully treated with high doses of intravenous corticosteroids, plasma exchanges and rituximab. Two months earlier, neutropenia had led to the discontinuation of valganciclovir prophylaxis, administered in the context of a CMV-seropositive donor/seronegative recipient status. Her immunosuppressive therapy included tacrolimus, mycophenolate mofetil and corticosteroids.
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