RESUMENSe presenta el caso de una paciente trasplantada renal de 60 años, quien presentó síndrome hemofagocítico secundario a infección por Citomegalovirus (CMV). La presentación clínica fue inespecífica con fiebre, bicitopenia, niveles altos de ferritina, hepatoesplenomegalia y hemofagocitósis confirmada por aspirado de médula ósea; evoluciono a shock séptico, siendo trasladada grave a la Unidad de cuidados intensivos, respondiendo favorablemente luego de 3 semanas de tratamiento antibiótico con meropenen, vancomicina, retiro de inmunosupresores, ganciclovir, caspofungina, y metilprednisolona. Cursó durante toda su complicación con función renal normal. En Perú no se ha descrito algún caso de síndrome hemofagocítico secundario a infección por Citomegalovirus en un paciente trasplantado renal, por lo que consideramos importante su difusión. Es importante la sospecha precoz de esta patología, ya que la mortalidad es alta llegando al 50% y la evolución depende de un tratamiento adecuado y temprano, tal como sucedió con nuestra paciente.PALABRAS CLAVE: Linfohistiocitosis hemofagocítica, citomegalovirus, trasplante de riñón. (Fuente: DeCS BIREME). SUMMARYWe report the case of a 60-year-old female renal transplant patient who presented with an hemophagocytic syndrome due to cytomegalovirus infection. Clinical presentation was non-specific with fever, bicytopenia, high ferritin levels, visceromegaly and hemophagocytosis documented in a bone marrow aspiration. The patient progressed to septic shock for which was transferred to the ICU where she recovered uneventfully after 3 weeks of treatment that included meropenem, vancomycin, suspension of immunosuppressive drugs, ganciclovir, casponfungin and methylprednisolone. Renal function was not altered throughout. This is the first report of this condition in Peru. Early suspicion is paramount as mortality is high and prognosis depends on early initiation of treatment as in this patient.
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