title: A case of acute rejection with adenovirus infection after ABO-incompatible kidney transplantation.
abstract: We report clinical and histopathologic findings of a case of acute rejection with adenovirus infection after kidney transplantation. A 63-yr-old woman with end-stage renal disease caused by lupus nephritis received an ABO-incompatible living kidney transplantation from her husband. On the 7th post-operative day (POD), she had fever, hematuria, and bladder irritation. Although she was treated with an antibiotic, the symptoms were not improved. We diagnosed adenovirus infection as positive with the urine shell vial method and blood PCR analysis. Cyclophosphamide was interrupted and immunoglobulin therapy was performed. However, urine output decreased and serum creatinine levels increased. An episode biopsy was performed on POD 20. We diagnosed acute antibody-mediated rejection. She was treated with plasma exchange for acute rejection and antiviral drug (rivabirin) for active adenovirus infection. However, the renal graft dysfunction was deemed irreversible and the renal graft was removed on POD 34. The graftectomy specimen showed acute rejection and acute tubular necrosis with adenovirus infection.
authors: Kidney Disease Center, Nagoya Daini Red Cross Hospital, Nagoya, Japan. t-komiya@kitano-hp.or.jp
authors: Toshiyuki
authors: T
authors: Komiya
authors: Norihiko
authors: N
authors: Goto
authors: Asami
authors: A
authors: Takeda
authors: Keiji
authors: K
authors: Horike
authors: Hiroshi
authors: H
authors: Onoda
authors: Kaoru
authors: K
authors: Sakai
authors: Ken
authors: K
authors: Kitamura
authors: Keiko
authors: K
authors: Yamamoto
authors: Tadashi
authors: T
authors: Oikawa
authors: Takaharu
authors: T
authors: Nagasaka
authors: Takahisa
authors: T
authors: Hiramitsu
authors: Syuichi
authors: S
authors: Simabukuro
authors: Keisuke
authors: K
authors: Suzuki
authors: Tetsuhiko
authors: T
authors: Sato
authors: Watarai
authors: W
authors: Yoshihiko
authors: Kazuharu
authors: K
authors: Uchida
authors: Kunio
authors: K
authors: Morozumi
mesh_terms: D000017:ABO Blood-Group System / Q000276:immunology*; D000208:Acute Disease; D000258:Adenovirus Infections, Human / Q000150:complications* / Q000175:diagnosis / Q000821:virology; D000260:Adenoviruses, Human / Q000276:immunology*; D000914:Antibodies, Viral / Q000032:analysis; D001706:Biopsy; D001787:Blood Group Incompatibility / Q000276:immunology*; D003937:Diagnosis, Differential; D005260:Female; D006084:Graft Rejection / Q000097:blood* / Q000175:diagnosis / Q000209:etiology; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects* / Q000276:immunology; D008875:Middle Aged
chemical_list: D000017:ABO Blood-Group System; D000914:Antibodies, Viral