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Systemic Herpes Simplex Virus Infection Following Cadaveric Renal Transplantation: A Case Report

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Author(s)
Y.N. KangH.K. OhY.C. ChangH.-C. KimS.L. LeeM. HwangK.-K. Park
Keimyung Author(s)
Kang, Yu Na
Department
Dept. of Pathology (병리학)
Journal Title
Transplantation Proceedings
Issued Date
2006
Volume
38
Issue
5
Abstract
Herpes simplex virus (HSV) infection usually occurs in immunocompromised or severely debilitated patients. It is not so common in patients with renal transplants. The diagnosis can only be made histologically. It usually occurs during or shortly after treatment of graft rejection with high-dose steroids. We have recently experienced a case of HSV esophagitis and nephropathy in the renal allograft biopsy, which was identified by histology, immunostaining, and electron microscopy. A 43-year-old woman underwent cadaveric renal transplantation with cyclosporine and prednisolone treatment. Twelve months later, she developed renal insufficiency and proteinuria. Allograft renal biopsy showed some evidence of acute rejection. She was treated with 3 successive days of methylprednisolone (1.0 g/d) intravenously and continued tapering of steroids. Three weeks after steroid pulse therapy, she had throat pain, oral cavity ulcer, dysphagia, and febrile sensation. Esophagoscopy revealed multiple confluent ulcers in the whole esophagus, and biopsy showed enlarged epithelial cells with prominent nuclei. Immunohistochemically, the epithelial cells were positive with a monoclonal antibody to HSV type 1. She was started on acyclovir intravenously, which was continued for a week. After a week, her symptoms began to improve and repeat endoscopy showed no residual esophagitis. A renal allograft infection with HSV can persist in heavily immunosuppressed patients with recurrent rejection episodes. HSV mainly affects tubular cells causing necrosis, a major reason for functional deterioration. A biopsy is required for diagnosis.
Keimyung Author(s)(Kor)
강유나
Publisher
School of Medicine
Citation
Y.N. Kang et al. (2006). Systemic Herpes Simplex Virus Infection Following Cadaveric Renal Transplantation: A Case Report. Transplantation Proceedings, 38(5), 1346–1347. doi: 10.1016/j.transproceed.2006.02.100
Type
Article
ISSN
0041-1345
Source
https://www.sciencedirect.com/science/article/pii/S0041134506001904?via%3Dihub
DOI
10.1016/j.transproceed.2006.02.100
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/34766
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Pathology (병리학)
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