Haemophagocytic syndrome--a life-threatening complication of renal transplantation

Ponticelli, Claudio; Alberighi, Ornella Della Casa

doi:10.1093/ndt/gfp282

Cited by 48 publications

(75 citation statements)

References 53 publications

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“…Renal dysfunction has been reported in patients with HLH [1,6], especially in relation to orthotopic renal transplantation [7,8], and renal macrophages have been noted as a general response to injury or inflammation [9][10][11]. Dysfunction can be manifest as acute renal insufficiency as part of multiple organ dysfunction, nephrotic syndrome, mild proteinuria, or merely an elevation of BUN [1,4,12,13].…”

Section: Discussionmentioning

confidence: 99%

“…Although clinical abnormalities have been associated with the presence of activated histiocytes in a particular affected organ [6], efforts to document such cells in the kidney of patients with renal dysfunction have been unsuccessful, even in cases in which macrophages have been found in other organs. Of particular note are patients who have received renal transplants and who have developed clear-cut renal failure secondary to HLH, but in whom the hemophagocytic macrophages are strikingly absent from the glomeruli despite their clear documentation in bone marrow or other organs [7,8].…”

Section: Discussionmentioning

confidence: 99%

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Glomerular hemophagocytic macrophages in a patient with proteinuria and clinical and laboratory features of hemophagocytic lymphohistiocytosis (HLH)

et al. 2011

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Hemophagocytic lymphohistiocytosis (HLH) is a heterogeneous disorder characterized by excessive activation and proliferation of nonmalignant histiocytes, which are commonly found in bone marrow, lymph nodes, spleen and liver in affected patients. Here, we report the presence of glomerular macrophages, including one showing erythrophagocytosis, on renal biopsy in a 25-year-old patient with clinical presentation and laboratory changes consistent with HLH. The clinical course was marked by persistent fever for 2 months, pleural and pericardial effusion, splenomegaly, lymphadenopathy, pancytopenia, cardiac arrhythmias, multiple organ dysfunction, and proteinuria, with demise after a 2-month hospitalization. Positive assay for Epstein-Barr virus (EBV), marked hyperferritinemia, hypofibrinogenemia, hypertriglyceridemia, elevated anti-nuclear antibody, proteinuria, and decreased circulating NK cells by flow cytometry were compatible with the diagnosis of HLH. We suggest that the glomerular hemophagocytic macrophages, which have not heretofore been described in the kidney of a patient with HLH, may have contributed to renal dysfunction manifest as proteinuria.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Glomerular hemophagocytic macrophages in a patient with proteinuria and clinical and laboratory features of hemophagocytic lymphohistiocytosis (HLH)

et al. 2011

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“…In international literature, about 80 HLH cases have been reported in kidney transplant patients (4)(5)(6)(7)(8)(9)(10)(11).…”

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confidence: 99%

“…Most cases were triggered by CMV infection (5,(12)(13)(14)(15)(16) or other herpesviruses such as Epstein-Barr virus, human herpesvirus (HHV)-8, and HHV-6 (4). Other cases were associated with adenovirus, parvovirus B19, BK polyomavirus, tuberculosis, bartonellosis, toxoplamosis, leishmaniasis, babebiosis, and histoplasmosis (4,6,8,9). HLH appears to be rare after renal transplantation, but it is possible that this syndrome has not been diagnosed in an undefined number of patients.…”

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confidence: 99%

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Cytomegalovirus infections, kidney transplantation, and secondary hemophagocytic lymphohistiocytosis

Famà

Mondello

Barberi

et al. 2014

Transplant Infectious Dis

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Canonical effects of cytokines on glomerulonephritis: A new outlook in nephrology

Zununi Vahed,

Hosseiniyan Khatibi,

Ardalan

2024

Medicinal Research Reviews

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Glomerulonephritis (GN) is an important cause of renal inflammation resulting from kidney‐targeted adaptive and innate immune responses and consequent glomerular damage. Given the lack of autoantibodies, immune complexes, or the infiltrating immune cells in some forms of GN, for example, focal segmental glomerulosclerosis and minimal change disease, along with paraneoplastic syndrome and a special form of renal involvement in some viral infections, the likeliest causative scenario would be secreted factors, mainly cytokine(s). Since cytokines can modulate the inflammatory mechanisms, severity, and clinical outcomes of GN, it is rational to consider the umbrella term of cytokine GN as a new outlook to reclassify a group of previously known GN. We focus here, particularly, on cytokines that have the central “canonical effect” in the development of GN.

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Haemophagocytic syndrome--a life-threatening complication of renal transplantation

Cited by 48 publications

References 53 publications

Glomerular hemophagocytic macrophages in a patient with proteinuria and clinical and laboratory features of hemophagocytic lymphohistiocytosis (HLH)

Glomerular hemophagocytic macrophages in a patient with proteinuria and clinical and laboratory features of hemophagocytic lymphohistiocytosis (HLH)

Cytomegalovirus infections, kidney transplantation, and secondary hemophagocytic lymphohistiocytosis

Canonical effects of cytokines on glomerulonephritis: A new outlook in nephrology

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