Fever, Haematuria, and Acute Graft Dysfunction in Renal Transplant Recipients Secondary to Adenovirus Infection: Two Case Reports
We report two cases of adenoviral infection in kidney transplant recipients that presented with different clinical characteristics under similar demographic and posttransplant conditions. The first case presented with fever, gross haematuria, and acute graft dysfunction 15 days following renal trans...
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| Format: | Article |
| Language: | English |
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Wiley
2013-01-01
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| Series: | Case Reports in Nephrology |
| Online Access: | http://dx.doi.org/10.1155/2013/195753 |
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| author | J. Ramírez I. C. Bostock A. Martin-Onraët S. Calleja A. Sánchez-Cedillo L. A. Navarro-Vargas A. L. Noriega-Salas O. Martínez-Mijangos N. O. Uribe-Uribe M. Vilatoba B. Gabilondo L. E. Morales-Buenrostro J. Alberú |
| author_facet | J. Ramírez I. C. Bostock A. Martin-Onraët S. Calleja A. Sánchez-Cedillo L. A. Navarro-Vargas A. L. Noriega-Salas O. Martínez-Mijangos N. O. Uribe-Uribe M. Vilatoba B. Gabilondo L. E. Morales-Buenrostro J. Alberú |
| author_sort | J. Ramírez |
| collection | DOAJ |
| description | We report two cases of adenoviral infection in kidney transplant recipients that presented with different clinical characteristics under similar demographic and posttransplant conditions. The first case presented with fever, gross haematuria, and acute graft dysfunction 15 days following renal transplantation. A graft biopsy, analyzed with immunohistochemistry, yielded negative results. However, the diagnosis was confirmed with blood and urine real-time PCR for adenovirus 3 days after the initial clinical manifestations. The immunosuppression dose was reduced, and ribavirin treatment was started, for which the patient quickly developed toxicity. Antiviral treatment allowed for transient response; however, a relapse occurred. The viral real-time PCR became negative upon immunosuppression reduction and administration of IVIG; graft function normalized. In the second case, the patient presented with fever and dysuria 1 month after transplantation. The initial imaging studies revealed graft enlargement and areas of hypoperfusion. In this case, the diagnosis was also confirmed with blood and urine real-time PCR for adenovirus 3 days after the initial clinical manifestations. Adenoviral nephritis was confirmed through a graft biopsy analyzed with light microscopy, immunohistochemistry, and PCR in frozen tissue. The immunosuppression dose was reduced, and IVIG was administered obtaining excellent clinical results along with a negative real-time PCR. |
| format | Article |
| id | doaj-art-95eb8d8f5f59455f8ae3caa870e31a9a |
| institution | Kabale University |
| issn | 2090-6641 2090-665X |
| language | English |
| publishDate | 2013-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Nephrology |
| spelling | doaj-art-95eb8d8f5f59455f8ae3caa870e31a9a2025-02-03T07:25:58ZengWileyCase Reports in Nephrology2090-66412090-665X2013-01-01201310.1155/2013/195753195753Fever, Haematuria, and Acute Graft Dysfunction in Renal Transplant Recipients Secondary to Adenovirus Infection: Two Case ReportsJ. Ramírez0I. C. Bostock1A. Martin-Onraët2S. Calleja3A. Sánchez-Cedillo4L. A. Navarro-Vargas5A. L. Noriega-Salas6O. Martínez-Mijangos7N. O. Uribe-Uribe8M. Vilatoba9B. Gabilondo10L. E. Morales-Buenrostro11J. Alberú12Department of Transplantation, National Institute of Medical Sciences and Nutrition, 14000 Mexico City, DF, MexicoDepartment of Transplantation, National Institute of Medical Sciences and Nutrition, 14000 Mexico City, DF, MexicoDepartment of Infectious Disease, National Institute of Medical Sciences and Nutrition, 14000 Mexico City, DF, MexicoDepartment of Transplantation, National Institute of Medical Sciences and Nutrition, 14000 Mexico City, DF, MexicoDepartment of Transplantation, National Institute of Medical Sciences and Nutrition, 14000 Mexico City, DF, MexicoDepartment of Transplantation, National Institute of Medical Sciences and Nutrition, 14000 Mexico City, DF, MexicoDepartment of Transplantation, National Institute of Medical Sciences and Nutrition, 14000 Mexico City, DF, MexicoDepartment of Anatomic Pathology, National Institute of Medical Sciences and Nutrition, 14000 Mexico City, DF, MexicoDepartment of Anatomic Pathology, National Institute of Medical Sciences and Nutrition, 14000 Mexico City, DF, MexicoDepartment of Transplantation, National Institute of Medical Sciences and Nutrition, 14000 Mexico City, DF, MexicoDepartment of Transplantation, National Institute of Medical Sciences and Nutrition, 14000 Mexico City, DF, MexicoDepartment of Nephrology-Mineral Metabolism, National Institute of Medical Sciences and Nutrition, 14000 Mexico City, DF, MexicoDepartment of Transplantation, National Institute of Medical Sciences and Nutrition, 14000 Mexico City, DF, MexicoWe report two cases of adenoviral infection in kidney transplant recipients that presented with different clinical characteristics under similar demographic and posttransplant conditions. The first case presented with fever, gross haematuria, and acute graft dysfunction 15 days following renal transplantation. A graft biopsy, analyzed with immunohistochemistry, yielded negative results. However, the diagnosis was confirmed with blood and urine real-time PCR for adenovirus 3 days after the initial clinical manifestations. The immunosuppression dose was reduced, and ribavirin treatment was started, for which the patient quickly developed toxicity. Antiviral treatment allowed for transient response; however, a relapse occurred. The viral real-time PCR became negative upon immunosuppression reduction and administration of IVIG; graft function normalized. In the second case, the patient presented with fever and dysuria 1 month after transplantation. The initial imaging studies revealed graft enlargement and areas of hypoperfusion. In this case, the diagnosis was also confirmed with blood and urine real-time PCR for adenovirus 3 days after the initial clinical manifestations. Adenoviral nephritis was confirmed through a graft biopsy analyzed with light microscopy, immunohistochemistry, and PCR in frozen tissue. The immunosuppression dose was reduced, and IVIG was administered obtaining excellent clinical results along with a negative real-time PCR.http://dx.doi.org/10.1155/2013/195753 |
| spellingShingle | J. Ramírez I. C. Bostock A. Martin-Onraët S. Calleja A. Sánchez-Cedillo L. A. Navarro-Vargas A. L. Noriega-Salas O. Martínez-Mijangos N. O. Uribe-Uribe M. Vilatoba B. Gabilondo L. E. Morales-Buenrostro J. Alberú Fever, Haematuria, and Acute Graft Dysfunction in Renal Transplant Recipients Secondary to Adenovirus Infection: Two Case Reports Case Reports in Nephrology |
| title | Fever, Haematuria, and Acute Graft Dysfunction in Renal Transplant Recipients Secondary to Adenovirus Infection: Two Case Reports |
| title_full | Fever, Haematuria, and Acute Graft Dysfunction in Renal Transplant Recipients Secondary to Adenovirus Infection: Two Case Reports |
| title_fullStr | Fever, Haematuria, and Acute Graft Dysfunction in Renal Transplant Recipients Secondary to Adenovirus Infection: Two Case Reports |
| title_full_unstemmed | Fever, Haematuria, and Acute Graft Dysfunction in Renal Transplant Recipients Secondary to Adenovirus Infection: Two Case Reports |
| title_short | Fever, Haematuria, and Acute Graft Dysfunction in Renal Transplant Recipients Secondary to Adenovirus Infection: Two Case Reports |
| title_sort | fever haematuria and acute graft dysfunction in renal transplant recipients secondary to adenovirus infection two case reports |
| url | http://dx.doi.org/10.1155/2013/195753 |
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