Late cytomegalovirus disease with atypical presentation in renal transplant patients: case reports

Transplantation Proceedings
Y BoobesS Abdulkhalik

Abstract

Cytomegalovirus (CMV) disease typically occurs 1 to 4 months (median 35 days) after solid organ transplantation. Recent reports documented that the natural history of CMV disease associated with solid organ transplantation has been modified as a result of the widespread use of potent immunosuppressents and antiviral prophylaxis. We herein report three pretransplant CMV seropositive recipients (with unknown donor status) who were diagnosed recently to display late and atypical CMV disease. Two men and one woman included two patients who presented with allograft dysfunction at 12 years and at 3 years after transplantation. Both patients showed increased serum creatinine approximately from baseline 200 to >400 micromol/L over 3 months in the absence of features of rejection or cyclosporine toxicity. A renal biopsy was refused by both patients. Two of the three patients presented with symptoms of enterocolitis (diarrhea, nausea, weight loss), which had persisted for more than 6 months. Other symptoms and signs of overt CMV disease (fever, leukopenia) were absent. None had pulmonary, hepatic, or other major organ involvement. In all patients IgG antibodies and CMV DNA by polymerase chain reaction were positive with negative IgM anti...Continue Reading

References

Apr 8, 1999·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Q NguyenE Whimbey
Apr 30, 2002·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Bryan N BeckerJohn D Pirsch
Jul 29, 2003·Transplantation·Friederike JochimsenWalter Zidek

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Citations

Feb 14, 2016·Nefrología : publicación oficial de la Sociedad Española Nefrologia·Antonio RíosPascual Parrilla
Aug 31, 2012·Transplant Infectious Disease : an Official Journal of the Transplantation Society·G PapadimitriouS Drakopoulos
Jan 29, 2010·Clinical Transplantation·Barry J BrowneArthur J Matas
Aug 11, 2020·Transplant Infectious Disease : an Official Journal of the Transplantation Society·Sadid F KhanJoseph Sasadeusz
Jul 19, 2013·The Korean Journal of Internal Medicine·Young Bin JooChul Woo Yang
Dec 19, 2020·Open Medicine·Armando CalogeroMichele Santangelo

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