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Literature review of allograft adenovirus nephritis and a case presenting as mass lesions in a transplanted kidney without symptoms of urinary tract infection or acute kidney injury
Author(s) -
Watanabe Megumi,
Kaneko Shuzo,
Usui Joichi,
Takahashi Kazuhiro,
Kawanishi Kunio,
TakahashiKobayashi Mayumi,
Shimizu Tatsuya,
Ishii Ryota,
Tawara Takashi,
Tsunoda Ryoya,
Nagai Kei,
Kawamura Tetsuya,
Fujita Akiko,
Kai Hirayasu,
Morito Naoki,
Saito Chie,
Oda Tatsuya,
Nagata Michio,
Yamagata Kunihiro
Publication year - 2021
Publication title -
transplant infectious disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.69
H-Index - 67
eISSN - 1399-3062
pISSN - 1398-2273
DOI - 10.1111/tid.13468
Subject(s) - medicine , acute kidney injury , kidney , urinary system , pathology , biopsy , kidney transplantation , nephritis , transplantation
Adenovirus (AdV) infection is a common complication in bone marrow/hematopoietic stem cell transplant and solid organ transplant recipients. AdV infection usually presents as hemorrhagic cystitis, but sometimes it can progress to acute kidney injury showing AdV nephritis (AdVN). We present the case of a 52‐year‐old Japanese female who had received a living kidney transplantation (KT) from her husband. At 21 months post‐KT, the patient presented with a fever, but no renal dysfunction and no abnormal urine findings. A contrast‐enhanced computed tomography (CT) scan revealed a few mass lesions with hypoperfusion in the transplanted kidney. An enhanced CT‐guided biopsy targeting one of these lesions revealed a necrotizing tubulointerstitial nephritis suggesting AdVN. The polymerase chain reaction tests for ADV were negative in a urine sample but positive in the sera and the frozen kidney biopsy samples. AdVN can manifest as an unusual pattern of acute lobar nephritis/acute focal bacterial nephritis‐like localization without symptoms of acute kidney injury or urinary tract infection. Enhanced CT can provide clues for clinical diagnosis.