Case Reports in Nephrology / 2013 / Article / Tab 1

Case Report

Fever, Haematuria, and Acute Graft Dysfunction in Renal Transplant Recipients Secondary to Adenovirus Infection: Two Case Reports

Table 1

Clinical manifestations and treatment response.

Case 1Case 2

1-Haplotype-match2-Haplotypes match
Induction therapy with BasiliximabNo induction therapy
21 days posttransplantation1 month posttransplantation
Gross hematuria and dysuriaSevere dysuria
No fever (36.7°C)Fever (38°C)
Urine analysis with 49 leukocytes and 135 erythrocytes per each high-power field.Urine analysis with 6 leukocytes and 4 bacteria per each high-power field.
Hb 11 g/dL, leukocytes 5.8 K/uL, and platelets 238 K/uL.Hb 13.9 g/dL, leukocytes 5.7 K/uL, and platelets 265 K/uL.
Renal ultrasound with moderate hydronephrosis, normal blood flow.Renal ultrasound with increase in size and echogenicity, data suggesting hypoperfusion.
Normal graft biopsyGraft biopsy with histopathological changes and (+) real-time PCR for adenovirus
Blood and urine real-time PCR (+) for adenovirus; CMV and BK virus serology (−)Blood and urine real-time PCR (+) for adenovirus; CMV and BK virus serology (−)
TAC dose reduced, MMF suspendedTAC dose reduced, MMF suspended
Treatment with ribavirin and IVIGTreatment with IVIG only
SCr returned to basal level (1.3 mg/dL) after treatment.SCr remained elevated (1.6 mg/dL) but with a recent tendency to decrease (1.4 mg/dL). Control graft biopsy with <2% fibrosis. Control graft biopsy with <2% fibrosis.

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