title: Clinical manifestations and evolution of infection by influenza A (H1N1) in kidney transplant recipients.
abstract: BACKGROUND
  The emergence of the pandemic outbreak of influenza A (H1N1) in April, 2009, represented a logistic challenge for public health. Although most infected patients presented clinical and evolutionary manifestations which were very similar to seasonal influenza, a significant number of individuals developed pneumonia and severe acute respiratory failure. The impact of influenza A (H1N1) in immunocompromised patients is not well established yet.
  
  
  METHODS
  This study aimed to analyze the clinical presentations and evolution of influenza A (H1N1) in 19 kidney transplant recipients. Influenza A (H1N1) infection was confirmed by RT-PCR in all patients. Treatment included antiviral therapy with oseltamivir phosphate and antibiotics.
  
  
  RESULTS
  The studied population was compounded mostly of white people (63%), males (79%), at a mean age of 38.6 ± 17 years and patients with at least one comorbidity (53%). Influenza A (H1N1) infection was identified 41.6 ± 49.6 months after transplantation. Common symptoms included cough (100%), fever (84%), dyspnea (79%), and myalgia (42%). Acute allograft dysfunction was observed in 42% of the patients. Five patients (26%) were admitted to the Intensive Care Unit, two (10%) required invasive ventilation support, and two (10%) required vasoactive drugs. Mortality rate was 10%.
  
  
  CONCLUSIONS
  Acute renal allograft dysfunction was a common finding. Clinical, laboratory, and evolutionary characteristics were comparable to those in the general population.
authors.affiliation: Departamento de Medicina, Universidade Federal de São Paulo.
authors.forename: Tainá Veras de Sandes
authors.initials: TV
authors.lastname: Freitas
authors.forename: Gislaine
authors.initials: G
authors.lastname: Ono
authors.forename: Luci
authors.initials: L
authors.lastname: Corrêa
authors.forename: Pollyane Sousa
authors.initials: PS
authors.lastname: Gomes
authors.forename: Nelson Zocoler
authors.initials: NZ
authors.lastname: Galante
authors.forename: Hélio
authors.initials: H
authors.lastname: Tedesco-Silva
authors.forename: Luís Fernando Aranha
authors.initials: LF
authors.lastname: Camargo
authors.forename: José Osmar
authors.initials: JO
authors.lastname: Medina-Pestana
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D053118:Influenza A Virus, H1N1 Subtype; D007251:Influenza, Human / Q000175:diagnosis* / Q000628:therapy*; D016030:Kidney Transplantation; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors