Use of rituximab in SARS-CoV-2-positive renal transplant recipient with EBV reactivation and probable haemophagocytic lymphohistiocytosis.
B cell
COVID-19
EBV reactivation
Haemophagocytic lymphohistiocytosis
Renal transplant
Rituximab
Journal
CEN case reports
ISSN: 2192-4449
Titre abrégé: CEN Case Rep
Pays: Japan
ID NLM: 101636244
Informations de publication
Date de publication:
02 2023
02 2023
Historique:
received:
21
01
2022
accepted:
24
05
2022
pubmed:
22
6
2022
medline:
4
2
2023
entrez:
21
6
2022
Statut:
ppublish
Résumé
We present a case of a rapid clinical recovery in a critically ill kidney transplant recipient with SARS-CoV-2 positivity, Epstein-Barr virus (EBV) reactivation and probable secondary hemophagocytic lymphohistiocytosis (HLH) treated with etoposide-free regimen, based on dexamethasone and a single dose of rituximab. Although rituximab is often a part of EBV-HLH treatment strategy, its use in simultaneous Coronavirus 2019 disease (COVID-19) and solid-organ transplantation has not been reported yet. We review the current evidence for the potential of SARS-CoV-2 to trigger EBV reactivation, leading to a severe clinical illness. Finally, we compare the clinical features of hyper-inflammatory response typical for severe COVID-19 and classical secondary HLH and discuss the benefits of therapeutic B-cell depletion in both conditions.
Identifiants
pubmed: 35729310
doi: 10.1007/s13730-022-00711-4
pii: 10.1007/s13730-022-00711-4
pmc: PMC9213214
doi:
Substances chimiques
Rituximab
4F4X42SYQ6
Types de publication
Case Reports
Review
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
27-31Informations de copyright
© 2022. The Author(s).
Références
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