Adenovirus infection of a renal allograft.
One month after renal transplantation, a 60-year-old man developed acute allograft dysfunction associated with gross hematuria and dysuria. Urinary cytological examination showed viral inclusion-bearing epithelial cells. A renal transplant biopsy specimen showed granulomatous interstitial nephritis, tubular necrosis, and ground glass-like intranuclear viral inclusion bodies in tubular cells caused by an adenovirus (ADV) infection. A reduction in baseline immunosuppressive therapy resulted in rapid normalization of allograft function and ultimately viral clearance. We report this case not only to illustrate an exceptional manifestation of an ADV infection in a renal allograft, but also to highlight the beneficial effect of reduction in immunosuppressive therapy on viral replication and clinical outcome.
Asim
Muhammad
M
Department of Renal Medicine, Hamad General Hospital, Doha, Qatar.
Chong-Lopez
Agustin
A
Nickeleit
Volker
V
D058186:Acute Kidney Injury / Q000473:pathology / Q000821:virology; D000256:Adenoviridae / Q000187:drug effects / Q000302:isolation & purification; D000257:Adenoviridae Infections / Q000175:diagnosis* / Q000188:drug therapy; D000890:Anti-Infective Agents / Q000627:therapeutic use; D016572:Cyclosporine / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D004334:Drug Administration Schedule; D006801:Humans; D007165:Immunosuppression Therapy / Q000009:adverse effects / Q000379:methods; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D007181:Inclusion Bodies, Viral / Q000187:drug effects / Q000473:pathology; D016030:Kidney Transplantation / Q000009:adverse effects* / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009643:Norfloxacin / Q000627:therapeutic use; D009894:Opportunistic Infections / Q000175:diagnosis / Q000188:drug therapy; D014184:Transplantation, Homologous
D000890:Anti-Infective Agents; D007166:Immunosuppressive Agents; D016572:Cyclosporine; D009643:Norfloxacin