ANCA Vasculitis and Hemophagocytic Lymphohistiocytosis following a Fecal Microbiota Transplant
A 69-year-old female with antisynthetase syndrome, a history of multiple recurrent infections, and documented previous negative titres for anti-neutrophil cystoplasmic antibody (ANCA) suddenly developed a de novo MPO-ANCA-associated glomerulonephritis three weeks after a fecal microbiota transplanta...
Saved in:
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2018-01-01
|
| Series: | Case Reports in Rheumatology |
| Online Access: | http://dx.doi.org/10.1155/2018/9263537 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849410170323468288 |
|---|---|
| author | Adam Amlani Amy Bromley Aurore Fifi-Mah |
| author_facet | Adam Amlani Amy Bromley Aurore Fifi-Mah |
| author_sort | Adam Amlani |
| collection | DOAJ |
| description | A 69-year-old female with antisynthetase syndrome, a history of multiple recurrent infections, and documented previous negative titres for anti-neutrophil cystoplasmic antibody (ANCA) suddenly developed a de novo MPO-ANCA-associated glomerulonephritis three weeks after a fecal microbiota transplantation (FMT) for recurrent Clostridium difficile infections. Six months following her FMT and less than two weeks following treatment for urosepsis, she developed severe cholestasis, a markedly elevated ferritin and hypertriglyceridemia. An initial liver biopsy was suggestive of drug-induced liver injury and thus she was treated with supportive care. After she failed to improve, a second liver biopsy supported the diagnosis of hemophagocytic lymphohistiocytosis (HLH). This case highlights difficulties surrounding the early diagnosis of HLH and also questions the role of FMT and/or recurrent infections as a trigger for ANCA-associated vasculitis. |
| format | Article |
| id | doaj-art-801eee4404354c94afd240beae0aa55d |
| institution | Kabale University |
| issn | 2090-6889 2090-6897 |
| language | English |
| publishDate | 2018-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Rheumatology |
| spelling | doaj-art-801eee4404354c94afd240beae0aa55d2025-08-20T03:35:14ZengWileyCase Reports in Rheumatology2090-68892090-68972018-01-01201810.1155/2018/92635379263537ANCA Vasculitis and Hemophagocytic Lymphohistiocytosis following a Fecal Microbiota TransplantAdam Amlani0Amy Bromley1Aurore Fifi-Mah2Department of Internal Medicine, University of Calgary, Calgary, AB, CanadaDepartment of Pathology, University of Calgary, Calgary, AB, CanadaDepartment of Internal Medicine, Division of Rheumatology, University of Calgary, Calgary, AB, CanadaA 69-year-old female with antisynthetase syndrome, a history of multiple recurrent infections, and documented previous negative titres for anti-neutrophil cystoplasmic antibody (ANCA) suddenly developed a de novo MPO-ANCA-associated glomerulonephritis three weeks after a fecal microbiota transplantation (FMT) for recurrent Clostridium difficile infections. Six months following her FMT and less than two weeks following treatment for urosepsis, she developed severe cholestasis, a markedly elevated ferritin and hypertriglyceridemia. An initial liver biopsy was suggestive of drug-induced liver injury and thus she was treated with supportive care. After she failed to improve, a second liver biopsy supported the diagnosis of hemophagocytic lymphohistiocytosis (HLH). This case highlights difficulties surrounding the early diagnosis of HLH and also questions the role of FMT and/or recurrent infections as a trigger for ANCA-associated vasculitis.http://dx.doi.org/10.1155/2018/9263537 |
| spellingShingle | Adam Amlani Amy Bromley Aurore Fifi-Mah ANCA Vasculitis and Hemophagocytic Lymphohistiocytosis following a Fecal Microbiota Transplant Case Reports in Rheumatology |
| title | ANCA Vasculitis and Hemophagocytic Lymphohistiocytosis following a Fecal Microbiota Transplant |
| title_full | ANCA Vasculitis and Hemophagocytic Lymphohistiocytosis following a Fecal Microbiota Transplant |
| title_fullStr | ANCA Vasculitis and Hemophagocytic Lymphohistiocytosis following a Fecal Microbiota Transplant |
| title_full_unstemmed | ANCA Vasculitis and Hemophagocytic Lymphohistiocytosis following a Fecal Microbiota Transplant |
| title_short | ANCA Vasculitis and Hemophagocytic Lymphohistiocytosis following a Fecal Microbiota Transplant |
| title_sort | anca vasculitis and hemophagocytic lymphohistiocytosis following a fecal microbiota transplant |
| url | http://dx.doi.org/10.1155/2018/9263537 |
| work_keys_str_mv | AT adamamlani ancavasculitisandhemophagocyticlymphohistiocytosisfollowingafecalmicrobiotatransplant AT amybromley ancavasculitisandhemophagocyticlymphohistiocytosisfollowingafecalmicrobiotatransplant AT aurorefifimah ancavasculitisandhemophagocyticlymphohistiocytosisfollowingafecalmicrobiotatransplant |