Acute cytomegalovirus infection complicated by venous thrombosis in a renal transplant recipient.
We report a case of simultaneous acute cytomegalovirus infection and venous thrombosis in a renal transplant recipient. On posttransplant month 3, the patient started complaining of left leg pain and swelling. Tibiopopliteal and femoral deep venous thrombosis were confirmed by Doppler ultrasonography. A serological test for CMV ELISA was strongly positive for IgM antibodies. Acute CMV infection was diagnosed by serum quantitative DNA polymerase chain reaction. Genetic predisposing risk factors for thrombosis (eg, protein C and S deficiency, factor V Leiden and prothrombin G20210A mutations, and antithrombin III deficiency) were not present. Results of tests for anticardiolipin antibodies, lupus anticoagulant, and antinuclear antibodies were also negative. No other clinical or biologic risk factors for thrombosis were detected in the patient. The patient responded well to intravenous gancyclovir and low-molecular weight heparin therapy. He was discharged in good condition. Our observation suggests that acute CMV infection may be the cause of a thrombotic event in renal transplant recipients.
Sengul
S
S
Ankara University School of Medicine, Department of Nephrology, Ankara, Turkey. sengul@medicine.ankara.edu.tr
Bozkus
Y
Y
Kutlay
S
S
Keven
K
K
Erturk
S
S
Erbay
B
B
D000208:Acute Disease; D000328:Adult; D000925:Anticoagulants / Q000627:therapeutic use; D000998:Antiviral Agents / Q000627:therapeutic use; D003586:Cytomegalovirus Infections / Q000175:diagnosis* / Q000188:drug therapy; D015774:Ganciclovir / Q000627:therapeutic use; D020022:Genetic Predisposition to Disease; D006495:Heparin, Low-Molecular-Weight / Q000627:therapeutic use; D006801:Humans; D007676:Kidney Failure, Chronic / Q000601:surgery*; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D016133:Polymerase Chain Reaction; D011183:Postoperative Complications / Q000175:diagnosis* / Q000821:virology; D020246:Venous Thrombosis / Q000175:diagnosis* / Q000188:drug therapy / Q000235:genetics
D000925:Anticoagulants; D000998:Antiviral Agents; D006495:Heparin, Low-Molecular-Weight; D015774:Ganciclovir