Severe Necrotizing Adenovirus Tubulointerstitial Nephritis in a Kidney Transplant Recipient
Joint Authors
Koffron, Alan
Zhang, Ping L.
Parasuraman, Ravi
Samarapungavan, Dilip
Rocher, Leslie
Source
Case Reports in Transplantation
Issue
Vol. 2013, Issue 2013 (31 Dec. 2013), pp.1-5, 5 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2013-08-28
Country of Publication
Egypt
No. of Pages
5
Main Subjects
Abstract EN
Adenoviruses (AdV) are emerging pathogens with a prevalence of 11% viruria and 6.5% viremia in kidney transplant recipients.
Although AdV infection is common, interstitial nephritis (ADVIN) is rare with only 13 biopsy proven cases reported in the literature.
We report a case of severe ADVIN with characteristic histological features that includes severe necrotizing granulomatous lesion with widespread tubular basement membrane rupture and hyperchromatic smudgy intranuclear inclusions in the tubular epithelial cells.
The patient was asymptomatic at presentation, and the high AdV viral load (quantitative PCR>2,000,000 copies/mL in the urine and 646,642 copies/mL in the serum) confirmed the diagnosis.
The patient showed excellent response to a combination of immunosuppression reduction, intravenous cidofovir, and immunoglobulin therapy resulting in complete resolution of infection and recovery of allograft function.
Awareness of characteristic biopsy findings may help to clinch the diagnosis early which is essential since the disseminated infection is associated with high mortality of 18% in kidney transplant recipients.
Cidofovir is considered the agent of choice for AdV infection in immunocompromised despite lack of randomized trials, and the addition of intravenous immunoglobulin may aid in resolution of infection while help prevention of rejection.
American Psychological Association (APA)
Parasuraman, Ravi& Zhang, Ping L.& Samarapungavan, Dilip& Rocher, Leslie& Koffron, Alan. 2013. Severe Necrotizing Adenovirus Tubulointerstitial Nephritis in a Kidney Transplant Recipient. Case Reports in Transplantation،Vol. 2013, no. 2013, pp.1-5.
https://search.emarefa.net/detail/BIM-512258
Modern Language Association (MLA)
Parasuraman, Ravi…[et al.]. Severe Necrotizing Adenovirus Tubulointerstitial Nephritis in a Kidney Transplant Recipient. Case Reports in Transplantation No. 2013 (2013), pp.1-5.
https://search.emarefa.net/detail/BIM-512258
American Medical Association (AMA)
Parasuraman, Ravi& Zhang, Ping L.& Samarapungavan, Dilip& Rocher, Leslie& Koffron, Alan. Severe Necrotizing Adenovirus Tubulointerstitial Nephritis in a Kidney Transplant Recipient. Case Reports in Transplantation. 2013. Vol. 2013, no. 2013, pp.1-5.
https://search.emarefa.net/detail/BIM-512258
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-512258