Hemophagocytic histiocytosis (HH) in renal transplant recipients under ciclosporin therapy: report of the first two cases.

Hematophagocytic histiocytosis is a clinicopathologic syndrome associating fever, liver dysfunction, blood cytopenia and coagulation abnormalities with hematophagocytosis in bone marrow and lymphoïd organs. This syndrome is found in immunocompromized patients and is triggered by infection. We describe herein the first 2 cases of HH in renal transplant recipients treated with ciclosporin. In our 1st case, H.H. was not recognized early and the patient died. In the 2nd case, prompt diagnosis associated to an anti-infectious treatment led to recovery. The clinician must thus be aware of the possibility of such a syndrome in renal transplant patients. Identification and treatment of the underlying infection is mandatory to avoid a fatal outcome.