title: Autoimmune hemolytic anemia and idiopathic thrombocytopenic purpura in pediatric solid organ transplant recipients, report of five cases and review of the literature.
abstract: Cytopenias are common among pediatric SOT; however, autoimmune cytopenias are infrequently reported. We report five cases of autoimmune cytopenias in pediatric LT patients: two with isolated IgG-mediated AIHA, two with ITP, and one with Evans syndrome (ITP and AIHA). All patients were maintained on tacrolimus as immunosuppression. Viral illness commonly preceded the autoimmune cytopenias. All patients responded well to medical therapy (steroids, intravenous immunoglobulin, and rituximab) and lowering tacrolimus serum level. Prognosis appears to be worse when more than one cell line (e.g., Evans syndrome) is affected, and/or there is no preceding viral illness. A critical literature review of autoimmune cytopenias in children following SOT is conducted. Autoimmune cytopenias are a rarely reported complication of pediatric SOT, but clinicians taking care of pediatric transplant recipients need to be aware of this complication.
authors: Department of Gastroenterology, Phoenix Children's Hospital, Phoenix, AZ 85016, USA. tmiloh@phoenixchildrens.com
authors: Tamir
authors: T
authors: Miloh
authors: Ronen
authors: R
authors: Arnon
authors: Elizabeth
authors: E
authors: Roman
authors: Anne
authors: A
authors: Hurlet
authors: Nanda
authors: N
authors: Kerkar
authors: Birte
authors: B
authors: Wistinghausen
mesh_terms: D000744:Anemia, Hemolytic, Autoimmune / Q000188:drug therapy / Q000209:etiology*; D002648:Child; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007223:Infant; D016031:Liver Transplantation / Q000009:adverse effects; D008297:Male; D016377:Organ Transplantation / Q000009:adverse effects*; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000188:drug therapy / Q000209:etiology*; D016559:Tacrolimus / Q000627:therapeutic use
chemical_list: D007166:Immunosuppressive Agents; D016559:Tacrolimus