Disseminated Adenovirus Nephritis After Kidney Transplantation

doi:10.1016/j.ekir.2017.08.004

Case Reports

. 2017 Aug 12;3(1):19-23.

doi: 10.1016/j.ekir.2017.08.004. eCollection 2018 Jan.

Disseminated Adenovirus Nephritis After Kidney Transplantation

Timothy Hatlen^{1

2}, Henry Mroch³, Katherine Tuttle^{3

4}, Okechukwu Ojogho⁵, Michele Rooney⁶, Sara Desmond⁷, Samer Bani-Hani⁷

Affiliations

¹ Department of Medicine, Providence Sacred Heart Medical Center, Spokane, Washington, USA.
² Department of Infectious Diseases, Harbor-UCLA Medical Center, Torrance, California, USA.
³ Department of Nephrology, Providence Kidney Care Spokane, Spokane, Washington, USA.
⁴ Institute of Translational Health Sciences, Kidney Research Institute, and Nephrology Division, University of Washington, Seattle, Washington, USA.
⁵ Department of Transplant Surgery, Providence Transplant Surgery, Spokane, Washington, USA.
⁶ Department of Pathology, Incyte Diagnostics, Spokane, Washington, USA.
⁷ Department of Nephrology-Transplant Medicine, Providence Kidney Transplant, Spokane, Washington, USA.

PMID: 29340310
PMCID: PMC5762978
DOI: 10.1016/j.ekir.2017.08.004

Case Reports

Disseminated Adenovirus Nephritis After Kidney Transplantation

Timothy Hatlen et al. Kidney Int Rep. 2017.

. 2017 Aug 12;3(1):19-23.

doi: 10.1016/j.ekir.2017.08.004. eCollection 2018 Jan.

Authors

Timothy Hatlen^{1

2}, Henry Mroch³, Katherine Tuttle^{3

4}, Okechukwu Ojogho⁵, Michele Rooney⁶, Sara Desmond⁷, Samer Bani-Hani⁷

Affiliations

¹ Department of Medicine, Providence Sacred Heart Medical Center, Spokane, Washington, USA.
² Department of Infectious Diseases, Harbor-UCLA Medical Center, Torrance, California, USA.
³ Department of Nephrology, Providence Kidney Care Spokane, Spokane, Washington, USA.
⁴ Institute of Translational Health Sciences, Kidney Research Institute, and Nephrology Division, University of Washington, Seattle, Washington, USA.
⁵ Department of Transplant Surgery, Providence Transplant Surgery, Spokane, Washington, USA.
⁶ Department of Pathology, Incyte Diagnostics, Spokane, Washington, USA.
⁷ Department of Nephrology-Transplant Medicine, Providence Kidney Transplant, Spokane, Washington, USA.

PMID: 29340310
PMCID: PMC5762978
DOI: 10.1016/j.ekir.2017.08.004

No abstract available

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Figures

**Figure 1**
Kidney biopsy sample containing a virus-infected renal tubule. Most of the renal tubular epithelial cells are lost or damaged beyond recognition. Two of the residual epithelial cells contain “smudged” intranuclear viral inclusions typical of adenovirus, with nuclear enlargement and peripheral displacement of nuclear chromatin (black arrows). There is an associated intratubular and peritubular infiltrate consisting predominantly of distinct histiocytes with elongated, curved, and crinkled nuclei (open blue arrows). Periodic acid–Schiff stain, original magnification ×600.

**Figure 2**
Temporal trend of human adenovirus (HAdV) urine polymerase chain reaction (PCR), serum creatinine, and inception of immunotherapy. Discontinuation of mycophenolate mofetil and reduction of tacrolimus goal trough initiated at day 0, i.v. Ig 0.5 g/kg received on days 8 and 9.

See this image and copyright information in PMC

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References

1. Lion T. Adenovirus infections in immunocompetent and immunocompromised patients. Clin Microbiol Rev. 2014;27:441–462. - PMC - PubMed
1. Nanmoku K. Clinical characteristics and outcomes of adenovirus infection of the urinary tract after renal transplantation. Transpl Infect Dis. 2016;18:234–239. - PubMed
1. Watcharananan S.P. Adenovirus disease after kidney transplantation: course of infection and outcome in relation to blood viral load and immune recovery. Am J Transplant. 2011;11:1308–1314. - PubMed
1. Humar A., Kumar D., Mazzulli T. A surveillance study of adenovirus infection in adult solid organ transplant recipients. Am J Transplant. 2005;5:2555–2559. - PubMed
1. Kozlowski T., Nickeleit V., Andreoni K. Donor-transmitted adenovirus infection causing kidney allograft nephritis and graft loss. Transpl Infect Dis. 2011;13:168–173. - PubMed

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[1] Lion T. Adenovirus infections in immunocompetent and immunocompromised patients. Clin Microbiol Rev. 2014;27:441–462. - PMC - PubMed

[2] Lion T. Adenovirus infections in immunocompetent and immunocompromised patients. Clin Microbiol Rev. 2014;27:441–462. - PMC - PubMed

[3] Nanmoku K. Clinical characteristics and outcomes of adenovirus infection of the urinary tract after renal transplantation. Transpl Infect Dis. 2016;18:234–239. - PubMed

[4] Nanmoku K. Clinical characteristics and outcomes of adenovirus infection of the urinary tract after renal transplantation. Transpl Infect Dis. 2016;18:234–239. - PubMed

[5] Watcharananan S.P. Adenovirus disease after kidney transplantation: course of infection and outcome in relation to blood viral load and immune recovery. Am J Transplant. 2011;11:1308–1314. - PubMed

[6] Watcharananan S.P. Adenovirus disease after kidney transplantation: course of infection and outcome in relation to blood viral load and immune recovery. Am J Transplant. 2011;11:1308–1314. - PubMed

[7] Humar A., Kumar D., Mazzulli T. A surveillance study of adenovirus infection in adult solid organ transplant recipients. Am J Transplant. 2005;5:2555–2559. - PubMed

[8] Humar A., Kumar D., Mazzulli T. A surveillance study of adenovirus infection in adult solid organ transplant recipients. Am J Transplant. 2005;5:2555–2559. - PubMed

[9] Kozlowski T., Nickeleit V., Andreoni K. Donor-transmitted adenovirus infection causing kidney allograft nephritis and graft loss. Transpl Infect Dis. 2011;13:168–173. - PubMed

[10] Kozlowski T., Nickeleit V., Andreoni K. Donor-transmitted adenovirus infection causing kidney allograft nephritis and graft loss. Transpl Infect Dis. 2011;13:168–173. - PubMed

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Disseminated Adenovirus Nephritis After Kidney Transplantation

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Disseminated Adenovirus Nephritis After Kidney Transplantation

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