Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2014 Jun;7(3):289-92.
doi: 10.1093/ckj/sfu020. Epub 2014 Mar 23.

Allograft adenovirus nephritis

Kirsty Rady  1 , Giles Walters  1 , Michael Brown  2 , Girish Talaulikar  1
Affiliations

Allograft adenovirus nephritis

Kirsty Rady et al. Clin Kidney J. 2014 Jun.

Abstract

We present an uncommon case of allograft adenovirus tubulointerstitial nephritis in a 63-year-old male 6 weeks following cadaveric renal transplantation for end-stage renal failure secondary to hypertensive nephrosclerosis. The patient presented with acute onset of fevers, dysuria, haematuria and diarrhoea with acute graft dysfunction. A renal biopsy demonstrated necrotizing tubulointerstitial nephritis with viral cytopathic changes and no evidence of rejection. Adenovirus was identified as the pathogen. Treatment involved the reduction in the patient's usual immunosuppression, intravenous immunoglobulin, piperacillin-tazobactam and ganciclovir. We present the clinical and pathological findings of necrotizing adenoviral nephropathy, highlighting the importance of considering this diagnosis in renal transplant recipients presenting with interstitial nephritis in the setting of a systemic illness.

Keywords: adenovirus; nephritis; renal; transplant.

PubMed Disclaimer

Figures

Fig. 1.
Fig. 1.
Adenoviral particles on electron microscopy.
Fig. 2.
Fig. 2.
Adenoviral particles at high power.
Fig. 3.
Fig. 3.
Viral cytopathic changes identified in urine cytology.
Fig. 4.
Fig. 4.
Renal biopsy demonstrated widespread tubular damage with necrosis and a patchy but severe interstitial infiltrate.
See this image and copyright information in PMC

References

    1. Asim M, Chong-Lopez A, Nickeleit V. Adenovirus infection of a renal allograft. Am J Kidney Dis. 2003;41:696–702. - PubMed
    1. UpToDate. Epidemiology and clinical manifestations of adenovirus infections [Internet] 2013. http://www.uptodate.com .
    1. Duggan JM, Farrehi J, Duderstadt S, et al. Treatment with ganciclovir of adenovirus pneumonia in a cardiac transplant patient. Am J Med. 1997;103:439–440. - PubMed
    1. Kolankiewicz L, Pullman J, Raffield M, et al. Adenovirus nephritis and obstructive uropathy in a renal transplant recipient: case report and literature review. Nephrol Dial Transplant. 2010;3:388–392. - PMC - PubMed
    1. Lim AKH, Parsons S, Ierino F. Adenovirus tubulointerstitial nephritis presenting as a renal allograft space occupying lesion. Am J Transplant. 2005;5:2062–2066. - PubMed

LinkOut - more resources