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Case Reports
. 2018 Sep 25;8(3):198-206.
doi: 10.1159/000493092. eCollection 2018 Sep-Dec.

Three Severe Cases of Viral Infections with Post-Kidney Transplantation Successfully Confirmed by Polymerase Chain Reaction and Flow Cytometry

Keita Nakanishi  1 , Hiroshi Kaito  1 , Miki Ogi  2 , Denshi Takai  2 , Junya Fujimura  1 , Tomoko Horinouchi  1 , Tomohiko Yamamura  1 , Shogo Minamikawa  1 , Takeshi Ninchoji  1 , Kandai Nozu  1 , Ken-Ichi Imadome  3 , Kazumoto Iijima  1
Affiliations
Case Reports

Three Severe Cases of Viral Infections with Post-Kidney Transplantation Successfully Confirmed by Polymerase Chain Reaction and Flow Cytometry

Keita Nakanishi et al. Case Rep Nephrol Dial. .

Abstract

Viral infections in patients with post-kidney transplantation are often difficult to diagnose as well as treat. We herein report three cases with severe viral infections after kidney transplantation. All their causative pathogens could be detected promptly by polymerase chain reaction and flow cytometry during the early stages of infection. These examinations would also be of great use to monitor therapeutic responses and disease activity. It is indeed true that no specific treatment is available for most of the viral infections, but we should be aware that some infections, such as Epstein-Barr virus infection, can be treatable with prompt and specific treatment, such as rituximab.

Keywords: Flow cytometry; Kidney transplantation; Polymerase chain reaction; Post-transplantation lymphoproliferative disease; Rituximab; Viral infection.

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Figures

Fig. 1
Fig. 1
Time courses of three cases. a Case 1. Day 1 is the first day she was admitted. b Case 2. Day 1 is the first day he was admitted. c Case 3. Day 1 is the first day her fever occurred. ADV, adenovirus; CyA, cyclosporine; DEX, dexamethasone; MMF, mycophenolate mofetil; mPSL, methylprednisolone; RTX, rituximab; Tac, tacrolimus.
Fig. 2
Fig. 2
Bone marrow from case 1. Hemophagocytosis by macrophage was indicated.
See this image and copyright information in PMC

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