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Granulomatous tubulointerstitial nephritis in early renal allograft: a case report
Author(s) -
Yamamoto Izumi,
Yamaguchi Yutaka,
Horita Shigeru,
Tanabe Kazunari,
Toma Hiroshi
Publication year - 2007
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/j.1399-0012.2007.00713.x
Subject(s) - medicine , nephritis , transplantation , pathology , interstitial nephritis , kidney transplantation , biopsy , kidney , renal biopsy
Here we report a case of granulomatous tubulointerstitial nephritis occurring seven d after kidney transplantation. The development of macroscopic hematuria, acute prostatitis, a mild elevation of serum creatinine, and high‐grade fever together with a urine culture positive for adenovirus antigen suggested adenovirus infection. Episode biopsy seven d after kidney transplantation showed granulomatous tubulointerstitial nephritis evidenced by predominantly CD68‐positive cell infiltration and epithelioid cells at focal tubulointerstitial spaces with severe tubulitis, such as destruction of the tubular basement membrane. After intervention consisting of a reduction of the immunosuppressive therapy and administration of intravenous immunoglobulin (IVIG) and ganciclovir, renal function returned to normal, with a rapid recovery of the pathological as well as clinical features within a month. In renal allografts, adenovirus infection should be considered during the early phase following transplantation, even within seven d, especially when granulomatous tubulointerstitial nephritis is present.