Epstein-Barr virus-associated acute interstitial nephritis: infection or immunologic phenomenon?
Epstein-Barr virus (EBV) DNA in renal tissue in acute interstitial nephritis (IN) has not been previously reported. An 18-year-old male presented with a sore throat, fever, cervical lymphadenopathy, and oliguric renal failure. The rapid slide test for heterophile antibodies associated with infectious mononucleosis was positive, and a renal biopsy showed an acute interstitial nephritis. A polymerase chain reaction (PCR) assay identified EBV DNA in the renal biopsy. In situ hybridization (ISH) for EBV RNA and immunohistochemistry for latent membrane protein 1 of EBV were negative. Hemodialysis and prednisone 60 mg PO OD were administered and the s-creatinine dropped from 1,224 to 75 micromol/l over 9 days. The identification of EBV DNA in the kidney raises the possibility that direct infection plays a role in acute IN associated with EBV.
Cataudella
J A
JA
2058 Etherington Hall, Queen's University, Kingston, Ontario, K7L 3N6 Canada.
Young
I D
ID
Iliescu
Edward A
EA
D000208:Acute Disease; D000293:Adolescent; D004279:DNA, Viral / Q000302:isolation & purification; D020031:Epstein-Barr Virus Infections / Q000209:etiology* / Q000276:immunology / Q000821:virology; D004854:Herpesvirus 4, Human / Q000302:isolation & purification / Q000472:pathogenicity; D006801:Humans; D007244:Infectious Mononucleosis / Q000276:immunology / Q000821:virology; D007668:Kidney / Q000473:pathology / Q000821:virology; D008297:Male; D009395:Nephritis, Interstitial / Q000209:etiology* / Q000276:immunology / Q000821:virology
D004279:DNA, Viral