Adenovirus infection of the renal allograft with sparing of pancreas graft function in the recipient of a combined kidney-pancreas transplant

Transplantation
S C MathurP F Shanley

Abstract

We report a case of adenovirus infection of the renal allograft in a combined kidney/pancreas transplant recipient. The clinical presentation was renal allograft failure, which eventually reversed. The pancreatic graft function remained stable. A renal biopsy showed massive tubular necrosis associated with a prominent granulomatous reaction. The process had a striking regional distribution within the kidney with the injury and inflammation limited to the outer medulla. Adenovirus type 11 was isolated from renal tissue by culture, and adenovirus was demonstrated by immunofluorescence and electron microscopy in the kidney biopsy. Immunosuppression may result in unusual patterns of response to infectious agents. This case demonstrated tropism of the adenovirus to only selected tubules within the kidney, with sparing of other organ function including, specifically, the pancreas allograft. The differential diagnosis of a granulomatous reaction in the transplant kidney must be expanded to include viral infection, in particular, adenovirus.

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Citations

Jun 29, 2006·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Michael G Ison
Aug 4, 2012·Clinical Journal of the American Society of Nephrology : CJASN·Parmjeet Randhawa, Roslyn B Mannon
Mar 4, 2003·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Muhammad AsimVolker Nickeleit
Jan 6, 2009·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Ariana GaspertThomas Fehr
Jul 6, 2005·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·Andy Kim Ho LimFrancesco Ierino
Feb 13, 2009·Transplant International : Official Journal of the European Society for Organ Transplantation·Jeremy L HensleyHugo J R Bonatti
Jul 15, 2009·Clinical Transplantation·Toshiyuki KomiyaKunio Morozumi
Oct 16, 2010·Transplant Infectious Disease : an Official Journal of the Transplantation Society·K SujeetA El-Meanawy
Feb 24, 2011·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·M C VarmaC N Kotton
Oct 10, 2003·Pathology, Research and Practice·Nicolaus FriedrichsReinhard Buettner
Apr 17, 2004·Transplantation·Benedetto BrunoRobert C Hackman

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