ANCA Vasculitis and Hemophagocytic Lymphohistiocytosis following a Fecal Microbiota Transplant

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dc.contributor.authorAmlani, Adam
dc.contributor.authorBromley, Amy
dc.contributor.authorFifi-Mah, Aurore
dc.date.accessioned2018-09-27T11:15:24Z
dc.date.available2018-09-27T11:15:24Z
dc.date.issued2018-02-18
dc.date.updated2018-09-27T11:15:24Z
dc.description.abstractA 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.
dc.description.versionPeer Reviewed
dc.identifier.citationAdam Amlani, Amy Bromley, and Aurore Fifi-Mah, “ANCA Vasculitis and Hemophagocytic Lymphohistiocytosis following a Fecal Microbiota Transplant,” Case Reports in Rheumatology, vol. 2018, Article ID 9263537, 3 pages, 2018. doi:10.1155/2018/9263537
dc.identifier.doihttp://dx.doi.org/10.11575/PRISM/33010
dc.identifier.urihttp://dx.doi.org/10.1155/2018/9263537
dc.identifier.urihttp://hdl.handle.net/1880/108074
dc.language.rfc3066en
dc.rights.holderCopyright © 2018 Adam Amlani et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
dc.titleANCA Vasculitis and Hemophagocytic Lymphohistiocytosis following a Fecal Microbiota Transplant
dc.typeJournal Article
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