title: Fulminant Epstein-Barr virus-associated hemophagocytic syndrome in a renal transplant patient and review of the literature.
abstract: We describe a rare fulminant case of Epstein-Barr virus-associated hemophagocytic syndrome (HPS) in a 37-year-old female renal transplant patient, indistinguishable from severe sepsis clinically and in the laboratory. HPS involves rapidly escalating immune system activation, resulting in a cytokine cascade, which can, especially in immunocompromised patients, lead to multi-organ failure, and even death. Thirty-two Herpesviridae-associated HPS cases in renal transplant patients have been reported and are reviewed. Overall mortality is 47% (15/32 cases).
authors: Infectious Diseases Unit, Faculty of Medicine, Aristotle University School of Health Sciences, Hippokration Hospital, Thessaloniki, Greece.
authors: I
authors: I
authors: Romiopoulos
authors: Infectious Diseases Unit, Faculty of Medicine, Aristotle University School of Health Sciences, Hippokration Hospital, Thessaloniki, Greece.
authors: A
authors: A
authors: Pyrpasopoulou
authors: 4th Internal Medicine Department, Faculty of Medicine, Aristotle University School of Health Sciences, Hippokration Hospital, Thessaloniki, Greece.
authors: I
authors: I
authors: Onoufriadis
authors: Intensive Care Unit, Hippokration Hospital, Thessaloniki, Greece.
authors: E
authors: E
authors: Massa
authors: Intensive Care Unit, Hippokration Hospital, Thessaloniki, Greece.
authors: E
authors: E
authors: Mouloudi
authors: Intensive Care Unit, Hippokration Hospital, Thessaloniki, Greece.
authors: C
authors: C
authors: Kydona
authors: Intensive Care Unit, Hippokration Hospital, Thessaloniki, Greece.
authors: T
authors: T
authors: Giasnetsova
authors: Intensive Care Unit, Hippokration Hospital, Thessaloniki, Greece.
authors: N
authors: N
authors: Gerogianni
authors: Transplantation Department, Faculty of Medicine, Aristotle University School of Health Sciences, Hippokration Hospital, Thessaloniki, Greece.
authors: G
authors: G
authors: Myserlis
authors: Transplantation Department, Faculty of Medicine, Aristotle University School of Health Sciences, Hippokration Hospital, Thessaloniki, Greece.
authors: F
authors: F
authors: Solonaki
authors: Transplantation Department, Faculty of Medicine, Aristotle University School of Health Sciences, Hippokration Hospital, Thessaloniki, Greece.
authors: M
authors: M
authors: Nikodimopoulou
authors: 4th Internal Medicine Department, Faculty of Medicine, Aristotle University School of Health Sciences, Hippokration Hospital, Thessaloniki, Greece.
authors: E
authors: E
authors: Mandala
authors: Infectious Diseases Unit, Faculty of Medicine, Aristotle University School of Health Sciences, Hippokration Hospital, Thessaloniki, Greece.|3rd Department of Pediatrics, Aristotle University, Hippokration General Hospital, Thessaloniki, Greece.
authors: C
authors: C
authors: Antachopoulos
authors: Infectious Diseases Unit, Faculty of Medicine, Aristotle University School of Health Sciences, Hippokration Hospital, Thessaloniki, Greece. roilides@med.auth.gr.|3rd Department of Pediatrics, Aristotle University, Hippokration General Hospital, Thessaloniki, Greece. roilides@med.auth.gr.
authors: E
authors: E
authors: Roilides
mesh_terms: D000212:Acyclovir / Q000008:administration & dosage / Q000627:therapeutic use; D000998:Antiviral Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D003967:Diarrhea / Q000209:etiology; D004359:Drug Therapy, Combination; D020031:Epstein-Barr Virus Infections / Q000150:complications* / Q000188:drug therapy / Q000401:mortality / Q000821:virology; D017809:Fatal Outcome; D005260:Female; D005334:Fever / Q000209:etiology; D015774:Ganciclovir / Q000008:administration & dosage / Q000627:therapeutic use; D005922:Glomerulonephritis, IGA / Q000601:surgery*; D004854:Herpesvirus 4, Human / Q000302:isolation & purification*; D006801:Humans; D016867:Immunocompromised Host; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use; D016030:Kidney Transplantation / Q000009:adverse effects*; D051359:Lymphohistiocytosis, Hemophagocytic / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology / Q000401:mortality; D009102:Multiple Organ Failure / Q000209:etiology* / Q000401:mortality; D009846:Oliguria / Q000209:etiology
chemical_list: D000998:Antiviral Agents; D007166:Immunosuppressive Agents; D015774:Ganciclovir; D000212:Acyclovir
keywords: 
  EBV
  ; hemophagocytic syndrome; pancytopenia; renal transplantation