1/2. Granulomatous hepatitis and hemophagocytic syndrome after bacillus Calmette-Guerin bladder instillation.Intravesical instillations of bacillus Calmette-Guerin are frequently used for treating superficial bladder carcinoma which is considered a safe treatment. We describe an unusual complication with hemophagocytosis and granulomatous hepatitis. Prompt diagnosis and treatment with corticosteroids, anti-tuberculous agents and intravenous immunoglobulins led to a rapid recovery.- - - - - - - - - - ranking = 1keywords = still (Clic here for more details about this article) |
2/2. Hemophagocytic syndrome in kidney transplant recipients: report of four cases from a single center.BACKGROUND: The prognosis of hemophagocytic syndrome (HPS) in kidney transplant recipients is reported to be poor, however the optimal therapeutic approach is still unclear. patients AND methods: The clinical and follow-up data of the 4 patients with HPS (3 male, 1 female; age 39.7 /- 11.3 years) among 368 kidney transplant recipients during a 5-year period were retrospectively analyzed. RESULTS: HPS developed 35-61 days in the post-transplant period. All 4 patients presented with fever. Hepatosplenomegaly and lymphadenopathy were observed only in the first patient. Laboratory tests revealed pancytopenia and hyperferritinemia in all patients, but elevated liver enzymes were observed in 3. Two patients had cytomegalovirus infection, and 1 had Epstein-Barr virus infection. Three patients died despite aggressive supportive therapy, however the fourth case survived after graft nephrectomy. CONCLUSION: HPS pathogenesis in kidney transplants appears to be related with the graft itself. Graft nephrectomy may be the preferable therapeutic approach for kidney transplant recipients with HPS resistant to standard supportive therapy.- - - - - - - - - - ranking = 0.2keywords = still (Clic here for more details about this article) |