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Reactivation of Hemophagocytic Lymphohistiocytosis Triggered by Antithymocyte
Globulin
#MMPMID29225252
Matsuda K
; Toyama K
; Toya T
; Ikemura M
; Nakamura F
; Kurokawa M
Intern Med
2018[Feb]; 57
(4
): 583-586
PMID29225252
show ga
A 16-year-old boy with Epstein-Barr virus-associated hemophagocytic
lymphohistiocytosis (HLH) underwent allogeneic hematopoietic stem cell
transplantation after conditioning with fludarabine, melphalan, total body
irradiation, and rabbit antithymocyte globulin (ATG). A severe, persistent
infusion reaction occurred after the initial administration of ATG.
Investigations showed a rapid increase in the levels of liver enzymes and
ferritin, and the reactivation of HLH was confirmed by marked hemophagocytosis in
the bone marrow. Treatment with pulse glucocorticoid therapy resulted in the
improvement of HLH. This is the first case of HLH reactivation triggered by ATG.
Physicians should therefore be cautious of HLH reactivation, especially when a
severe and prolonged infusion reaction occurs.
|*Hematopoietic Stem Cell Transplantation
[MESH]
|Adolescent
[MESH]
|Antilymphocyte Serum/*adverse effects/therapeutic use
[MESH]