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Acute renal failure due to adenovirus-associated obstructive uropathy and necrotizing tubulointerstitial nephritis in a bone marrow transplant recipient

2003; Springer Nature; Volume: 31; Issue: 12 Linguagem: Inglês

10.1038/sj.bmt.1704077

1476-5365

Kosuke Mori, Takao Yoshihara, Y Nishimura, Masaya Uchida, Kaoruko Katsura, Yoshio Kawase, Ikuyoshi Hatano, Hiroyuki Ishida, Tomohiro Chiyonobu, Yasuo Kasubuchi, Akira Morimoto, Tomoko Teramura, Shinsaku Imashuku,

Herpesvirus Infections and Treatments

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.