Rotavirus-associated hemophagocytic lymphohistiocytosis (HLH) after hematopoietic stem cell transplantation for familial HLH

Pediatr Int. 2015 Apr;57(2):e77-80. doi: 10.1111/ped.12567. Epub 2015 Feb 24.

Abstract

Hemophagocytic lymphohistiocytosis (HLH) is a life-threatening disorder of immune regulation. HLH consists of two forms: familial and acquired, the latter which occurs in association with infection, malignancy, rheumatic disease and acquired immune deficiency. Herein, we report a case of acquired HLH in a child who had received allogeneic hematopoietic stem cell transplantation for familial HLH with UNC13D mutation. Based on microbiology, only rotavirus was identified as a possible organism triggering HLH. The patient's fulminant clinical course included acute respiratory failure, a sepsis-like pattern, disseminated intravascular coagulopathy, and rhabdomyolysis, leading to multiorgan failure and death from septic shock.

Keywords: acquired; familial; hematopoietic stem cell transplantation; hemophagocytic lymphohistiocytosis; rotavirus.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Fatal Outcome
  • Female
  • Hematopoietic Stem Cell Transplantation / adverse effects*
  • Humans
  • Infant
  • Lymphohistiocytosis, Hemophagocytic / diagnosis
  • Lymphohistiocytosis, Hemophagocytic / therapy
  • Lymphohistiocytosis, Hemophagocytic / virology*
  • Membrane Proteins / genetics
  • Multiple Organ Failure
  • Mutation
  • Rotavirus / isolation & purification*
  • Rotavirus Infections / diagnosis
  • Rotavirus Infections / therapy
  • Rotavirus Infections / virology*

Substances

  • Membrane Proteins
  • UNC13D protein, human