Case Report: Early-Onset Adenovirus Nephritis Without Hemorrhagic Cystitis Following Kidney Transplantation.

Autor: Attieh RM; Department of Transplant, Division of Kidney and Pancreas Transplant, Mayo Clinic, Jacksonville, Florida; Division of Kidney Diseases and Hypertension, Glomerular Center at Northwell Health, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Great Neck, New York., Roach D; Department of Infectious Disease, Mayo Clinic, Jacksonville, Florida., Wadei HM; Department of Transplant, Division of Kidney and Pancreas Transplant, Mayo Clinic, Jacksonville, Florida., Parikh N; Department of Transplant, Division of Kidney and Pancreas Transplant, Mayo Clinic, Jacksonville, Florida., Me HM; Department of Transplant, Division of Kidney and Pancreas Transplant, Mayo Clinic, Phoenix, Arizona., Durvasula RV; Department of Infectious Disease, Mayo Clinic, Jacksonville, Florida., Oring J; Department of Infectious Disease, Mayo Clinic, Jacksonville, Florida. Electronic address: Oring.Justin@mayo.edu.
Jazyk: angličtina
Zdroj: Transplantation proceedings [Transplant Proc] 2024 Jun; Vol. 56 (5), pp. 1196-1199. Date of Electronic Publication: 2024 Jun 08.
DOI: 10.1016/j.transproceed.2024.05.018
Abstrakt: We report a case of adenovirus nephritis (ADVN) in a kidney transplant recipient (KTR) occurring within 8 days post-transplantation. The patient, a 35-year-old male, displayed systemic symptoms, high-grade fever, and acute kidney injury (AKI) without signs of hemorrhagic cystitis (HC). Extensive diagnostic workup revealed widespread necrotizing granulomatous inflammation in the allograft, leading to the identification of adenovirus (ADV) via histopathology and polymerase chain reaction (PCR) testing. The source of ADV transmission remained uncertain, raising questions about the potential donor-derived infection. Unlike typical ADVN cases, the patient exhibited no hematuria or urinary symptoms. The case underscores the atypical presentation of ADVN in KTRs, challenging the conventional understanding of its timeline, transmission routes, and associated clinical features. We discuss the diagnostic challenges, histological findings, and management strategies for ADVN, emphasizing the importance of considering this entity in KTRs with unexplained fever and AKI, even in the absence of classical urinary symptoms or hematuria.
Competing Interests: Declaration of competing interest All the authors declare no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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