We report the occurrence of human herpesvirus (HHV)-8 primary infection in an adult male kidney recipient. Four months after transplantation, the patient developed visceral Kaposi sarcoma, and 1 month later he presented with progressive and severe peripheral cytopenia, in the presence of a normocellular or hypercellular bone marrow (BM) with hemophagocytosis. HHV-8 was the sole pathogen detected by polymerase chain reaction either in the serum or in the BM. HHV-8 latent nuclear antigen was detected in immature progenitor cells from the BM. Immunosuppressive therapy was reduced, and the patient was treated with foscarnet for 2 weeks, leading to a dramatic normalization of blood cell counts, concomitantly with the disappearance of HHV-8 viremia. At the end of antiviral therapy, the patient received chemotherapy, and Kaposi sarcoma regressed in 2 months. Severe peripheral cytopenia may be a post-transplant complication after HHV-8 infection, for which treatment with foscarnet seems appropriate.
Severe pancytopenia and hemophagocytosis after HHV-8 primary infection in a renal transplant patient successfully treated with foscarnet / Luppi, Mario; Barozzi, Patrizia; Rasini, V; Riva, Giovanni; Re, A; Rossi, Giorgio; Setti, G; Sandrini, S; Facchetti, F; Torelli, Giuseppe. - In: TRANSPLANTATION. - ISSN 0041-1337. - STAMPA. - 74:1(2002), pp. 131-133. [10.1097/00007890-200207150-00023]