85 Acute Kidney Injury and Hemophagocytic Lymphohistiocytosis (HLH) caused by Human Granulocytic Anaplasmosis (HGA)

2019 ◽  
Vol 73 (5) ◽  
pp. 664
Keyword(s):  
Acute Kidney Injury ◽  
Hemophagocytic Lymphohistiocytosis ◽  
Kidney Injury ◽  
Human Granulocytic Anaplasmosis ◽  
Granulocytic Anaplasmosis

Acute Kidney Injury Associated With Human Granulocytic Anaplasmosis: A Case Report

2019 ◽  
Vol 74 (5) ◽  
pp. 696-699
Author(s):  
Min Zhuo ◽  
Hila Calev ◽  
Staci J. Saunders ◽  
Jiahua Li ◽  
Isaac E. Stillman ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Case Report ◽  
Kidney Injury ◽  
Human Granulocytic Anaplasmosis ◽  
Granulocytic Anaplasmosis

MO412THE RISK FACTORS OF ACUTE KIDNEY INJURY CAUSED BY HEMOPHAGOCYTIC LYMPHOHISTIOCYTOSIS

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Siwen Wang ◽  
Jia Yang ◽  
Chen Xuelian ◽  
Jiaojiao Zhou ◽  
Lichuan Yang
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Hemophagocytic Lymphohistiocytosis ◽  
Strong Predictor ◽  
Laboratory Data ◽  
Clinical Manifestations ◽  
Gastrointestinal Symptoms ◽  
Kidney Injury ◽  
Total Bilirubin Level ◽  
Risk Of Death

Abstract Background and Aims Hemophagocytic lymphohistiocytosis (HLH) is a syndrome characterized by overproduction of proinflammatory cytokines and hemophagocytosis. Acute kidney injury (AKI) is the most common complication of HLH in the kidney, which is a strong predictor of poor prognosis. In this retrospective study, we aimed to find the risk factors of AKI in patients with HLH. Method We screened all adult patients with HLH admitted to West China Hospital of Sichuan University from January 2009 to June 2019. Patients in this study were secondary HLH according to the HLH diagnostic criteria revised by the Histocyte Society in 2004. Patients with HLH were excluded from the study if they had a functioning kidney transplant, received renal replacement therapy (RRT) in the past month, suffered from end-stage renal disease (ESRD), or had the renal malignant tumor. We collected basic information, clinical manifestations, and laboratory data of patients from electronic medical records. Results A total of 600 patients with confirmed diagnosis of secondary HLH are included in our analysis. There are 199(33.2%)HLH-induced AKI patients, among whom 37.2%, 32.7%, and 30.2% are classified as AKI I, II, and III, respectively, according to the 2012 KDIGO (Kidney Disease: Improving Global Outcomes) guideline. Overall hospital mortality is 176(29.3%), and the number of deaths in patients with AKI was much higher than that in patients without AKI (53.3% versus 17.5%, P < 0.001). The risk factors of AKI in patients with HLH were hyperphosphatemia (P<0.001, OR 5.448, 95%CI 2.951-10.059) , vasopressor(P<0.001, OR 3.485, 95%CI 2.114-5.746), heart failure (P=0.044, 0R 2.336, 95%CI 1.022-5.340), gastrointestinal symptoms (P=0.043, OR 1.877, 95%CI 1.021-3.453), increased heart rate (P=0.005, OR 1.017, 95%CI 1.005-1.029), elevated total bilirubin level(P<0.001, OR 1.004, 95%CI 1.002-1.007), and hypoproteinemia (P=0.034, OR 0.939, 95%CI 0.886-0.995). Conclusion The incidence of AKI was higher in patients with HLH, and the risk of death was significantly higher in HLH patients with AKI. A variety of risk factors are related to the occurrence of HLH-induced AKI. Identifying and correcting them early in clinical diagnosis and treatment may reduce the incidence of AKI in patients with HLH and improve the prognosis of them.

scholarly journals A novel mutation of adenosine deaminase causing SCID presenting as hemophagocytic lymphohistiocytosis with acute kidney injury

2020 ◽  
Vol 191 (3) ◽  
pp. 509-512
Author(s):  
Aakash C. Chidambaram ◽  
Kaushik Maulik ◽  
Jaikumar G. Ramamoorthy ◽  
Narayanan Parameswaran
Keyword(s):  
Acute Kidney Injury ◽  
Adenosine Deaminase ◽  
Hemophagocytic Lymphohistiocytosis ◽  
Novel Mutation ◽  
Kidney Injury

Acute Kidney Injury in Adults With Hemophagocytic Lymphohistiocytosis

2015 ◽  
Vol 65 (6) ◽  
pp. 851-859 ◽  
Author(s):  
Florence Aulagnon ◽  
Nathanael Lapidus ◽  
Emmanuel Canet ◽  
Lionel Galicier ◽  
David Boutboul ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Hemophagocytic Lymphohistiocytosis ◽  
Kidney Injury

scholarly journals Acute kidney injury induced by thrombotic microangiopathy in a patient with hemophagocytic lymphohistiocytosis

2016 ◽  
Vol 17 (1) ◽  
Author(s):  
Myoung Nam Bae ◽  
Dae Hun Kwak ◽  
Se Jun Park ◽  
Bum Soon Choi ◽  
Cheol Whee Park ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Thrombotic Microangiopathy ◽  
Hemophagocytic Lymphohistiocytosis ◽  
Kidney Injury

scholarly journals P0626THE RISK FACTORS OF ACUTE KIDNEY INJURY CAUSED BY HEMOPHAGOCYTIC LYMPHOHISTIOCYTOSIS

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Siwen Wang ◽  
Jiaojiao Zhou ◽  
Jia Yang ◽  
Lichuan Yang ◽  
Xin Wang
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
Heart Rate ◽  
Acute Kidney Injury ◽  
Prothrombin Time ◽  
Bilirubin Level ◽  
Hemophagocytic Lymphohistiocytosis ◽  
Total Bilirubin ◽  
Kidney Injury ◽  
Total Bilirubin Level

Abstract Background and Aims Hemophagocytic lymphohistiocytosis (HLH) is a syndrome caused by uncontrolled natural killer (NK) cell and cytotoxic T cell activation, resulting in the overproduction of proinflammatory cytokines and hemophagocytosis. Acute kidney injury (AKI) characterized by rapid loss of renal excretion function is the most common complication of HLH in the kidney. In this retrospective study, we aimed to find the risk factors of AKI in patients with HLH. Method This study included adult patients with HLH admitted in West China Hospital of Sichuan University from January 2009 to June 2019. Patients with HLH were excluded from the study if they had a functioning kidney transplant, received renal replacement therapy (RRT) in the past month, suffered from end-stage renal disease (ESRD) or had the renal malignant tumor. The diagnosis of HLH was based on the HLH diagnostic criteria revised by the Histocyte Society in 2004 and AKI was defined according to the 2012 KDIGO (Kidney Disease: Improving Global Outcomes) guideline. We collected basic information, clinical manifestations and laboratory data of patients from electronic medical records. Results We analyzed 294 patients this time, of whom 95 (32.3%) developed AKI. The patients were divided into two groups according to the occurrence of AKI. The mortality rate in the AKI group was significantly higher than that in the non-AKI group (40.0% VS 12.6%; p<0.001). The risk factors of AKI in patients with HLH were hyperphosphatemia [Odds Ratio (OR) 3.825; 95% Confidence Interval (CI) 1.647-8.886; p=0.002] ,heart failure (OR 2.972; 95% CI 1.029-8.584; p=0.044), increased heart rate (OR 1.025; 95% CI 1.008-1.043; p=0.004), prolonged prothrombin time (OR 1.025; 95% CI 1.001-1.049; p=0.041), elevated total bilirubin level (OR 1.003; 95% CI 1.000-1.007; p=0.030), and hypoproteinemia (OR 0.915; 95% CI 0.842-0.994; p=0.035). Conclusion The incidence of AKI in HLH patients is frequent, and the risk of death in HLH patients with AKI is significantly higher. The occurrence of AKI in patients with HLH is related to hyperphosphatemia, heart failure, increased heart rate, prolonged prothrombin time, elevated total bilirubin level, and hypoproteinemia.

scholarly journals Human granulocytic anaplasmosis combined with rhabdomyolysis: a case report

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jeong Min Cho ◽  
Jeonghyun Chang ◽  
Dong-Min Kim ◽  
Yee Gyung Kwak ◽  
Chong Rae Cho ◽  
...  
Keyword(s):  
Kidney Injury ◽  
Peripheral Blood Smear ◽  
Complete Recovery ◽  
Whole Body ◽  
Severe Thrombocytopenia ◽  
Human Granulocytic Anaplasmosis ◽  
Granulocytic Anaplasmosis ◽  
General Weakness ◽  
History Of ◽  
Associated Risk Factors

Abstract Background Human granulocytic anaplasmosis (HGA) is a systemic inflammatory response caused by the rickettsial bacterium Anaplasma phagocytophilum. Rhabdomyolysis and acute kidney injury (AKI) are rare complications of HGA. Here, we report a case of HGA concurrent with rhabdomyolysis and AKI in an elderly patient. Case presentation An 84-year old woman with a medical history of hypertension was hospitalised after two days of fever, dizziness, whole body pain, and general weakness. Laboratory investigations showed severe thrombocytopenia, leukopenia, impaired renal function, and elevated cardiac enzyme and myoglobin levels. On the day after admission, peripheral blood smear revealed morula inclusions in neutrophils, a suggestive finding of HGA. Real-time polymerase chain reaction (PCR) results indicated the presence of A. phagocytophilum. Antibiotics were de-escalated to doxycycline monotherapy. After 10 days of antibiotic treatment, laboratory tests showed complete recovery from HGA complicated with rhabdomyolysis and AKI. Conclusions HGA can lead to serious complications in patients with associated risk factors. Therefore, in patients with HGA accompanied by rhabdomyolysis, management with antibiotics and hydration should be initiated immediately, and not delayed until diagnostic confirmation.

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