Enteric Adenovirus Infection in Pediatric Small Bowel Transplant Recipients
Autor: | George V. Mazariegos, Janet Walpusk, Maria Parizhskaya, Ronald Jaffe |
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Rok vydání: | 2001 |
Předmět: |
Graft Rejection
Male Pathology medicine.medical_specialty Virus Pathology and Forensic Medicine Enteritis Adenovirus Infections Human Diagnosis Differential Postoperative Complications Immune system Intestine Small Biopsy Humans Medicine Adenovirus infection Child Cell Nucleus Inclusion Bodies Lung medicine.diagnostic_test business.industry Adenoviruses Human General Medicine medicine.disease Transplantation Enterocytes medicine.anatomical_structure Child Preschool Pediatrics Perinatology and Child Health Immunohistochemistry Female business |
Zdroj: | Pediatric and Developmental Pathology. 4:122-128 |
ISSN: | 1615-5742 1093-5266 |
DOI: | 10.1007/s100240010132 |
Popis: | Three of 70 small bowel transplant recipients were diagnosed with adenovirus enteritis. The biopsies were performed for surveillance in one patient at 2.7 years after transplantation and in two symptomatic children 1.5 years and 4.5 months after transplantation. In all three patients the characteristic epithelial changes were not noted by the primary observers. Two biopsies had been called “suggestive of acute rejection” and both patients had been so treated. One biopsy had been diagnosed as “regenerative”. Once the epithelial changes were recognized as being viral, confirmation was possible by stool culture in one patient, immunohistochemistry in two patients, or by lift technique of the H&E sections for electron microscopy. The immune suppression was reduced and none of the patients developed disseminated infection. As in other transplanted organs, such as lung and liver, adenovirus infection may be limited largely to the allograft but can be destructive. Early recognition of the characteristic changes that are illustrated can lead to confirmation of the virus and appropriate reduction of immune suppression. A mistaken diagnosis of rejection and augmentation of immune suppression can lead to viral dissemination and potential fatality. |
Databáze: | OpenAIRE |
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