End-stage renal disease due to polyomavirus in a cardiac transplant patient.
BACKGROUND
A 51-year-old male orthotopic cardiac transplant recipient experienced a prolonged rejection episode immediately after transplantation. Three years and 5 months after transplantation, he presented with lower extremity swelling; at this presentation, the patient's serum creatinine level was 345 micromol/l (3.9 mg/dl), his urinalysis was trace positive for both protein and blood, the urinary sediment had no casts and his 24-hour urine collection showed 750 mg protein. The patient's renal function deteriorated over the next month, with his serum creatinine level reaching a peak of 530 micromol/l (6 mg/dl). He died 4 years and 3 months after transplantation as a result of an arrhythmia.


METHODS
Physical examination, urine and blood analyses, ultrasound-guided renal biopsy and autopsy.


METHODS
Polyomavirus-associated nephropathy with the development of end-stage renal disease.


RESULTS
Adjustment of immunosuppressive therapy and initiation of hemodialysis.
Maddirala
Supriya
S
Division of Nephrology and Hypertension, University of Florida Jacksonville, Shands Jacksonville, Jacksonville, FL 32209, USA. supriya.maddirala@jax.ufl.edu
Pitha
Jan V
JV
Cowley
Benjamin D
BD
Haragsim
Lukas
L
D001344:Autopsy; D002311:Cardiomyopathy, Dilated / Q000175:diagnosis / Q000601:surgery; D018450:Disease Progression; D017809:Fatal Outcome; D006084:Graft Rejection / Q000209:etiology / Q000821:virology*; D016027:Heart Transplantation / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D007150:Immunohistochemistry; D007676:Kidney Failure, Chronic / Q000209:etiology / Q000473:pathology* / Q000628:therapy / Q000821:virology*; D007677:Kidney Function Tests; D008297:Male; D008875:Middle Aged; D027601:Polyomavirus Infections / Q000150:complications* / Q000175:diagnosis; D011183:Postoperative Complications; D006435:Renal Dialysis; D012720:Severity of Illness Index