Summary:
Management of post-transplant complications caused by severe adenoviral infection remains a major therapeutic challenge. A 17-year-old male who had undergone bone marrow transplantation for the treatment of acute lymphoblastic leukemia developed complete anuria following hemorrhagic cystitis 34 days after the transplant procedure. The computed tomogram scan revealed bilateral hydronephrosis, indicating acute renal failure because of obstructive uropathy. The emergency procedure of percutaneous nephrostomy caused massive bleeding in the left kidney, which eventually required a nephrectomy. Adenovirus-positive severe necrotizing tubulointerstitial nephritis was the histopathological diagnosis. Post-transplant acute renal failure because of hydronephrosis, which could be complicated by adenovirus-induced renal parenchymal disease, is of great concern and may cause significant problems with interventional treatment.
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References
Shields AF, Hackman RC, Fife KH et al. Adenovirus infections in patients undergoing bone-marrow transplantation. N Engl J Med 1985; 312: 529–533.
Runde V, Ross S, Trenschel R et al. Adenoviral infection after allogeneic stem cell transplantation (SCT): report on 130 patients from a single SCT unit in a prospective multi center surveillance study. Bone Marrow Transplant 2001; 28: 51–57.
Ito M, Hirabayashi N, Uno Y et al. Necrotizing tubulointerstitial nephritis associated with adenovirus infection. Hum Pathol 1991; 22: 1225–1231.
Kapelushnik J, Verstandig A, Or R et al. Hydronephrosis in children after bone marrow transplantation: case reports. Bone Marrow Transplant 1996; 17: 873–875.
Hiraoka A, Teshima H, Mitsui H et al. Ureteric obstruction after allogeneic bone marrow transplantation: an unusual complication. Bone Marrow Transplant 1989; 4: 449–451.
Kawakami M, Ueda S, Maeda T et al. Vidarabine therapy for virus-associated cystitis after allogeneic bone marrow transplantation. Bone Marrow Transplant 1997; 20: 485–490.
Murphy CF, Wood DP, McRoberts JW et al. Adenovirus-associated hemorrhagic cystitis treated with intravenous ribabirin. J Urol 1993; 149: 565–566.
Peene P, Wilms G, Beart AL . Embolization of iatrogenic renal hemorrhage following percutaneous nephrostomy. Urologic Radiol 1990; 12: 84–87.
von der Recke P, Nielsen MB, Pedersen JF . Complications of ultrasound-guided nephrostomy. Acta Radiol 1994; 35: 452–454.
Teramura T, Naya M, Yoshihara T et al. Quantitative detection of serum adenovirus in a transplant recipient. Lancet 2002; 359: 1945.
Debbagh A, Dassouli B, Hafiani M et al. Acute renal insufficiency due to hydronephrosis. Ann Urol (Paris) 2001; 35: 26–29.
Erdogan O, Bulbul M, Demircin G et al. Acute necrotizing tubulointestinal nephritis due to systemic adenoviral infection. Pediatr Nephrol 2001; 16: 265–268.
Echavarria M, Forman M, van Tol MJD et al. Prediction of severe disseminated adenovirus infection by serum PCR. Lancet 2001; 358: 384–385.
Einsele H, Roosnek E, Rufer N et al. Infusion of cytomegalovirus(CMV)-specific T cells for the treatment of CMV infection not responding to antiviral chemotherapy. Blood 2002; 99: 3916–1922.
Chen FE, Liang RHS Lo JY, Yuen KY et al. Treatment of adenovirus-associated haemorrhagic cystitis with ganciclovir. Bone Marrow Transplant 1997; 20: 997–999.
Ribaud P, Scieux C, Freymuth F, Morinet F et al. Successful treatment of adenovirus disease with intravenous cidofovir in an unrelated stem-cell transplant recipient. Clin Infect Dis 1999; 28: 690–691.
Legrand F, Berrebi D, Houhou N et al. Early diagnosis of adenovirus infection and treatment with cidofovir after bone marrow transplantation in children. Bone Marrow Transplant 2001; 27: 621–626.
Haque T, Taylor C, Wilkie GM et al. Complete regression of posttransplant lymphoproliferative disease using partially HLA-matched Epstein-Barr virus-specific cytotoxic T cells. Transplantation 2001; 72: 1399–1402.
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Mori, K., Yoshihara, T., Nishimura, Y. et al. Acute renal failure due to adenovirus-associated obstructive uropathy and necrotizing tubulointerstitial nephritis in a bone marrow transplant recipient. Bone Marrow Transplant 31, 1173–1176 (2003). https://doi.org/10.1038/sj.bmt.1704077
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DOI: https://doi.org/10.1038/sj.bmt.1704077
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