Adenovirus infection of a renal allograft

Am J Kidney Dis. 2003 Mar;41(3):696-701. doi: 10.1053/ajkd.2003.50133.

Abstract

One month after renal transplantation, a 60-year-old man developed acute allograft dysfunction associated with gross hematuria and dysuria. Urinary cytological examination showed viral inclusion-bearing epithelial cells. A renal transplant biopsy specimen showed granulomatous interstitial nephritis, tubular necrosis, and ground glass-like intranuclear viral inclusion bodies in tubular cells caused by an adenovirus (ADV) infection. A reduction in baseline immunosuppressive therapy resulted in rapid normalization of allograft function and ultimately viral clearance. We report this case not only to illustrate an exceptional manifestation of an ADV infection in a renal allograft, but also to highlight the beneficial effect of reduction in immunosuppressive therapy on viral replication and clinical outcome.

Publication types

  • Case Reports

MeSH terms

  • Acute Kidney Injury / pathology
  • Acute Kidney Injury / virology
  • Adenoviridae / drug effects
  • Adenoviridae / isolation & purification
  • Adenoviridae Infections / diagnosis*
  • Adenoviridae Infections / drug therapy
  • Anti-Infective Agents / therapeutic use
  • Cyclosporine / administration & dosage
  • Cyclosporine / adverse effects
  • Cyclosporine / therapeutic use
  • Drug Administration Schedule
  • Humans
  • Immunosuppression Therapy / adverse effects
  • Immunosuppression Therapy / methods
  • Immunosuppressive Agents / administration & dosage
  • Immunosuppressive Agents / adverse effects
  • Immunosuppressive Agents / therapeutic use
  • Inclusion Bodies, Viral / drug effects
  • Inclusion Bodies, Viral / pathology
  • Kidney Transplantation / adverse effects*
  • Kidney Transplantation / methods*
  • Male
  • Middle Aged
  • Norfloxacin / therapeutic use
  • Opportunistic Infections / diagnosis
  • Opportunistic Infections / drug therapy
  • Transplantation, Homologous

Substances

  • Anti-Infective Agents
  • Immunosuppressive Agents
  • Cyclosporine
  • Norfloxacin