Cytomegalovirus Triggering Hemophagocytic Lymphohistiocytosis in a Kidney Transplant Recipient

Abstract

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.