Annals of Hematology

, Volume 97, Issue 8, pp 1493–1495 | Cite as

Late-onset hemophagocytic lymphohistiocytosis with varicella zoster virus and Epstein-Barr virus co-infection after umbilical cord blood transplantation

  • Koya Ono
  • Ken Murata
  • Atsushi Miyazaki
  • Naoki Tachibana
  • Toshitsugu Nakamura
  • Ryosei Nishimura
  • Akihiro Yachie
  • Keisei Kawa
  • Shintaro Shiobara
Letter to the Editor

Dear Editor,

Hemophagocytic lymphohistiocytosis (HLH) is a fatal syndrome characterized by systemic hypercytokinemia and subsequent multiorgan failure [1]. HLH can occur during the early period after cord blood transplantation (CBT) [2], but it is rare for HLH to occur years after CBT [3].

A 39-year-old man presented with systemic pain. He had previously suffered from high-risk myelodysplastic syndrome (MDS) and received unrelated CBT from a female donor mismatched at two HLA loci 4 years and 7 months prior to the visit. He continued to take 5 mg of prednisolone for chronic pulmonary graft-versus-host disease (GVHD).

On arrival, vesicles were observed over his whole body (Fig.  1a). Laboratory examination revealed a white blood cell count of 6020/μL, a hemoglobin level of 10.1 g/dL, and a platelet count of 97 × 10 3/μL. Moderate liver dysfunction (lactic dehydrogenase (LDH), 1012 IU/L) was noted. On viral serological tests, he was positive for varicella zoster virus (VZV) IgM and IgG. A...



The authors thank Dr. Yasushi Onishi (Department of Hematology and Rheumatology, Tohoku University Hospital) for his guidance and expertise in preparing this paper.

Compliance with ethical standards

This single case study was performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki.

Conflict of interest

The authors declare that they have no conflict of interest.

Informed consent

The patient provided informed consent.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of HematologySoka Municipal HospitalSokaJapan
  2. 2.Department of Hematology and RheumatologyTohoku UniversitySendaiJapan
  3. 3.Departments of HematologySuwa Red Cross HospitalSuwaJapan
  4. 4.Departments of DermatologySuwa Red Cross HospitalSuwaJapan
  5. 5.Departments of NephrologySuwa Red Cross HospitalSuwaJapan
  6. 6.Departments of PathologySuwa Red Cross HospitalSuwaJapan
  7. 7.Department of PediatricsKanazawa UniversityKanazawaJapan
  8. 8.Division of Hematology/OncologyOsaka Women’s and Children’s HospitalIzumiJapan
  9. 9.Japanese Red Cross Ishikawa Blood CenterKanazawaJapan

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