Hemophagocytic lymphohistiocytosis induced by Toxoplasma gondii infection diagnosed by a bone marrow biopsy and DNA next-generation sequencing in an allogeneic hematopoietic stem cell transplant recipient

被引：0

作者：

Obeid, Karam M. ^{[1
]}

Grzywacz, Bartosz ^{[2
]}

Ferrieri, Patricia ^{[2
]}

Arbefeville, Sophie ^{[2
]}

Slungaard, Arne ^{[3
]}

Betts, Brian ^{[3
]}

机构：

[1] Univ Minnesota, Div Infect Dis & Int Med, 420 Delaware St SE,MMC 250, Minneapolis, MN 55455 USA

[2] Univ Minnesota, Dept Lab Med & Pathol, Minneapolis, MN 55455 USA

[3] Univ Minnesota, Div Hematol Oncol & Transplantat, Minneapolis, MN 55455 USA

来源：

TRANSPLANT INFECTIOUS DISEASE | 2021年

关键词：

hematopoietic stem cell transplant; hemophagocytic lymphohistiocytosis; HLH; toxoplasmosis;

D O I：

10.1111/tid.13610

中图分类号：

R392 [医学免疫学]; Q939.91 [免疫学];

学科分类号：

100102 ;

摘要：

In the United States, toxoplasmosis following allogeneic hematopoietic stem transplant (allo-HCT) is very rare with a rate only between 0.5% and 2%. The reported rates of hemophagocytic lymphohistiocytosis (HLH) following allo-HCT range between 0.3% and 17%. Secondary HLH due to toxoplasmosis infection is extremely rare. Herein, we report a case of secondary HLH due to toxoplasmosis following allo-HCT. The diagnosis was reached by a bone marrow biopsy and confirmed by DNA next generation sequencing and immunohistochemical (IHC) staining. The IHC staining included CD1a, a stain previously known to react with cells infected by Leishmania, here we show CD1a staining of macrophages infected with Toxoplasma gondii. Our report highlights the utility of bone marrow biopsy in diagnosing parasitic infection underlying HLH in post-transplant settings. The pre-transplant evaluation of patients from low endemic countries, is a great opportunity to obtain a travel history to determine the risks and the preventative measures against opportunistic infections including toxoplasmosis.

引用

页数：6