Adenovirus-induced interstitial nephritis following umbilical cord blood transplant for chronic lymphocytic leukemia

Am J Kidney Dis. 2012 Jun;59(6):886-90. doi: 10.1053/j.ajkd.2011.10.056. Epub 2012 Mar 8.

Abstract

We present a case of a 27-year-old man who received an unrelated donor umbilical cord blood transplant for chronic lymphocytic leukemia. His postsurgery course was complicated by acute kidney injury, hemorrhagic cystitis, and pancytopenia. Transjugular kidney biopsy showed interstitial nephritis. Viral inclusions were present in tubular epithelial cells, and in situ hybridization studies confirmed the presence of adenovirus. Kidney function improved after a short course of cidofovir. Adenovirus-induced interstitial nephritis should be considered in the differential diagnosis in all cases of interstitial nephritis occurring in immunocompromised patients.

Publication types

  • Case Reports

MeSH terms

  • Acute Kidney Injury / therapy
  • Acute Kidney Injury / virology*
  • Adenoviridae Infections / diagnosis*
  • Adenoviridae Infections / drug therapy
  • Adenoviridae Infections / virology
  • Adult
  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage
  • Cidofovir
  • Cord Blood Stem Cell Transplantation / adverse effects*
  • Cord Blood Stem Cell Transplantation / methods
  • Cytosine / analogs & derivatives
  • Cytosine / therapeutic use
  • Fetal Blood
  • Follow-Up Studies
  • Humans
  • Immunocompromised Host / immunology
  • Leukemia, Lymphocytic, Chronic, B-Cell / complications
  • Leukemia, Lymphocytic, Chronic, B-Cell / immunology
  • Leukemia, Lymphocytic, Chronic, B-Cell / therapy*
  • Male
  • Nephritis, Interstitial / therapy
  • Nephritis, Interstitial / virology*
  • Organophosphonates / therapeutic use
  • Risk Assessment
  • Severity of Illness Index
  • Treatment Outcome
  • Unrelated Donors
  • Viremia / diagnosis
  • Viremia / drug therapy
  • Viremia / virology

Substances

  • Organophosphonates
  • Cytosine
  • Cidofovir