title: Sequential adenovirus infection of type 14 hemorrhagic cystitis and type 35 generalized infection after cord blood transplantation.
abstract: We report a case of a 29-year-old male patient with a generalized adenovirus (AdV) infection after cord blood transplantation (CBT) for acute myelocytic leukemia with maturation at 2nd complete remission. Before engraftment, hemorrhagic cystitis was caused by AdV, which resulted in hydronephrosis, renal failure, and adenoviremia on day 34. Forced diuresis, hemodialysis, withdrawal of cyclosporin A, and administration of gamma-globulin or vidarabine were not effective and the patient died of pulmonary alveolar hemorrhage on day 67. At autopsy, old inflammatory change only was observed in the bladder section. In the lungs and kidneys, granular deposits in the nucleus and a high copy number of AdV-DNA were observed. Molecular diagnosis using PCR-restriction fragment length polymorphism analysis demonstrated that AdV with the serotype 14 caused the cystitis. However, retrospective genome typing using PCR sequencing revealed the infection of AdV serotype 35 in the kidneys, lungs, and serum. The present case suggested that Adv infection could not be always caused by a single AdV serotype, and suggested that multiple serotype infection was very difficult to treat. It is desired that a consensus regarding the treatment of AdV infections is established.
authors.affiliation: Division of Hematology, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medicine and Dental Science, Asahimachi-dori 754, Niigata, 951-8510, Japan. abetaka@med.niigata-u.ac.jp.
authors.forename: Takashi
authors.initials: T
authors.lastname: Abe
authors.affiliation: Division of Bone Marrow Transplantation, Niigata University Medical and Dental Hospital, Niigata, Japan.
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Furukawa
authors.affiliation: Division of Bone Marrow Transplantation, Niigata University Medical and Dental Hospital, Niigata, Japan.
authors.forename: Masayoshi
authors.initials: M
authors.lastname: Masuko
authors.affiliation: Division of Hematology, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medicine and Dental Science, Asahimachi-dori 754, Niigata, 951-8510, Japan.
authors.forename: Atsunori
authors.initials: A
authors.lastname: Sugimoto
authors.affiliation: Division of Hematology, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medicine and Dental Science, Asahimachi-dori 754, Niigata, 951-8510, Japan.
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Okazuka
authors.affiliation: Division of Hematology, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medicine and Dental Science, Asahimachi-dori 754, Niigata, 951-8510, Japan.
authors.forename: Keiichiro
authors.initials: K
authors.lastname: Honma
authors.affiliation: Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medicine and Dental Science, Niigata, Japan.
authors.forename: Takeo
authors.initials: T
authors.lastname: Fujimura
authors.affiliation: Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medicine and Dental Science, Niigata, Japan.
authors.forename: Seitaro
authors.initials: S
authors.lastname: Iguchi
authors.affiliation: Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medicine and Dental Science, Niigata, Japan.
authors.forename: Shinichi
authors.initials: S
authors.lastname: Nishi
authors.affiliation: Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medicine and Dental Science, Niigata, Japan.
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Ueno
authors.affiliation: Division of Molecular Diagnostic Pathology, Niigata University Medical and Dental Hospital, Niigata, Japan.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Nagahashi
authors.affiliation: Division of Molecular Diagnostic Pathology, Niigata University Medical and Dental Hospital, Niigata, Japan.
authors.forename: Gen
authors.initials: G
authors.lastname: Watanabe
authors.affiliation: Division of Molecular Diagnostic Pathology, Niigata University Medical and Dental Hospital, Niigata, Japan.
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Ajioka
authors.affiliation: Niigata Prefecture Central Hospital, Niigata, Japan.
authors.forename: Noriatsu
authors.initials: N
authors.lastname: Isahai
authors.affiliation: Niigata Prefecture Central Hospital, Niigata, Japan.
authors.forename: Koichi
authors.initials: K
authors.lastname: Nagai
authors.affiliation: Kitazato-Otsuka Biomedical Assay Laboratories Co., LTD, Kanagawa, Japan.
authors.forename: Yukumasa
authors.initials: Y
authors.lastname: Kazuyama
authors.affiliation: Division of Hematology, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medicine and Dental Science, Asahimachi-dori 754, Niigata, 951-8510, Japan.
authors.forename: Yosifusa
authors.initials: Y
authors.lastname: Aizawa
mesh_terms: D000258:Adenovirus Infections, Human / Q000209:etiology*; D000328:Adult; D036101:Cord Blood Stem Cell Transplantation / Q000009:adverse effects*; D003556:Cystitis / Q000209:etiology* / Q000473:pathology / Q000821:virology; D017809:Fatal Outcome; D006470:Hemorrhage / Q000209:etiology* / Q000821:virology; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000628:therapy*; D008297:Male; D001743:Urinary Bladder / Q000473:pathology