Linfohistiocitosis hemofagocítica secundaria a histoplasmosis diseminada en un paciente trasplantado de riñón con lupus eritematoso sistémico

Monroy López LM, Polo Gómez I, Ramos Rincón ML, Martínez Castilla CA, Rodríguez Gómez JC, Rubio Gómez AV, Viñas Granadillo Álvaro J. Hemophagocytic lymphohistiocytosis secondary to disseminated histoplasmosis in a renal transplant patient with systemic lupus erythematosus. Rev. Colomb. Nefrol. [Internet]. 2026 May 28 [cited 2026 Aug. 15];13(1). Available from: https://revistanefrologia.org/index.php/rcn/article/view/997

Abstract

Background: Hemophagocytic lymphohistiocytosis (HLH) is a rare and life-threatening hyperinflammatory syndrome, particularly in immunosuppressed patients such as renal transplant recipients.

Objective: To describe a case of HLH secondary to disseminated histoplasmosis in a patient with systemic lupus erythematosus and kidney transplantation.

Case presentation: We report the case of a 31-year-old male with systemic lupus erythematosus and renal transplantation who presented with persistent fever and pancytopenia. Clinical, microbiological, and bone marrow studies were performed.

Discussion and conclusion: The patient met diagnostic criteria for HLH, with evidence of hemophagocytosis and infection by Histoplasma capsulatum. Treatment with liposomal amphotericin B followed by isavuconazole led to favorable clinical and hematological recovery.

https://doi.org/10.22265/acnef.13.1.997

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References

Mostaza-Fernández JL, Guerra Laso J, Carriedo Ule D, Ruiz de Morales JMG. Hemophagocytic lymphohistiocytosis associated with viral infections: Diagnostic challenge and therapeutic dilemma. Revista Clínica Española (English Edition). 2014; 214(6), 320-7. https://doi.org/10.1016/j.rceng.2014.03.004

Porras O. Linfohistiocitosis hemofagocítica, el espectro desde la enfermedad genética al síndrome de activación macrofágica. Rev Acta Médica Costarricense. 2011; 53(2), 71-8. https://doi.org/10.51481/amc.v53i2.728

Nieto-Ríos JF, Serna-Higuita LM, Guzman-Luna CE, Ocampo-Kohn C, Aristizábal-Alzate A, Ramírez I, et al. Histoplasmosis in Renal Transplant Patients in an Endemic Area at a Reference Hospital in Medellín, Colombia. Transplant Proc. 2014; 46(9), 3004-9. https://doi.org/10.1016/j.transproceed.2014.06.060

Nieto-Ríos JF, Morales-Contreras CL, Chacón-Jaimes DC, Benavides-Henao DA, Bello-Márquez DC, Serna-Higuita LM. Linfohistiocitosis hemofagocítica en trasplante renal. Iatreia. 2019; 32(4), 311-20. https://doi.org/10.17533/udea.iatreia.21

La Marle S, Richard-Colmant G, Fauvernier M, Ghesquières H, Hot A, Sève P, Jamilloux Y. Mortality and Associated Causes in Hemophagocytic Lymphohistiocytosis: A Multiple-Cause-of-Death Analysis in France. J. Clin. Med. 2023; 12(4), 1696. https://doi.org/10.3390/jcm12041696

Ashraf N, Kubat RC, Poplin V, Adenis AA, Denning DW, Wright L, et al. Re-drawing the Maps for Endemic Mycoses. Mycopathologia. 2020; 185, 843-65. https://doi.org/10.1007/s11046-020-00431-2

Contreras K, García P, Pinto J, Rodriguez P, Gónzalez C, Vargas Brochero MJ. Histoplasmosis diseminada y síndrome hemofagocítico en trasplante renal. Rev. Colomb. Nefrol. 2017; 4(1), 93-98. https://doi.org/10.22265/acnef.4.1.250

Carrillo B. J, Zuluaga Gómez CP, Kallmann M. Patrón nodular aleatorio. Revista Colombiana de Neumología. 2015; 27(2), 206-07. https://doi.org/10.30789/rcneumologia.v27.n2.2015.32

Egües Dubuc CA, Uriarte Ecenarro M, Meneses Villalba C, Aldasoro Cáceres V, Hernando Rubio I, Belzunegui Otano J. Síndrome hemofagocítico como manifestación clínica inicial del lupus eritematoso sistémico. Rematol Clin. 2014; 10(5), 321-4. https://doi.org/10.1016/j.reuma.2013.09.004

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Hemophagocytic lymphohistiocytosis secondary to disseminated histoplasmosis in a renal transplant patient with systemic lupus erythematosus

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