Allograft Dysfunction in Association with Cytomegalovirus Infection in a Renal Transplant Recipient

接受腎臟移植的病人因為須接受免疫抑制劑的治療所以感染是一個常見的問題。細胞巨大型病毒是感染移植接受體最重要的一隻病毒，但是直接侵犯移植的腎臟造成急性間質性腎炎卻不多見。細胞巨大型病毒的組織侵犯以腸胃道及肺臟為主。對於活動性細胞巨大型病毒造成的移植腎臟的功能異常有時候很容易與排斥混淆。我們報告一位60歲男性因尿毒而接受腎臟移植治療的病人因為漸進性的呼吸困難及合併急性腎功能惡化而住院。病人接受腎臟切片檢查，病理報告符合細胞巨大型病毒感染造成的急性間質性腎炎。接受抗病毒藥物ganciclovir治療後腎功能明顯恢復至以前的標準。我們建議當移植腎功能異常而找不到原因時，腎臟切片檢查對於鑑別細胞巨大型病毒感染、排斥和抗排斥藥的腎毒性(cyclosporin或tacrolimus)有很大的幫助。

關鍵字

細胞巨大型病毒；移植腎功能不全；腎移植

並列摘要

Infection is a common problem in renal transplant recipients due to immunodepression for prophylaxis and treatment of rejection. CMV is one of the most prevalent viruses, which infects transplant recipients. However, direct invasion of allograft kidney with complicated acute interstitial nephritis is not common. Tissue invasion by CMV is commonly found in the gastrointestinal tract and lungs. Active CMV infection is sometimes associated, or occasionally confused, with rejection episodes when allograft dysfunction is presented. We report a 60-year-old renal transplant recipient who suffered from gradual onset of dyspnea and acute exacerbation of allograft dysfunction. The result of renal biopsy showed acute tubulointerstitial nephritis in association with CMV infection. After ganciclovir treatment, renal function returned to baseline level. We suggest that renal biopsy is helpful in patients with allograft dysfunction in order to differentiate between CMV infection, rejection and calcineurin inhibitor nephrotoxicity.

並列關鍵字

CMV ； allograft dysfunction ； renal transplantation

國際替代計量

Allograft Dysfunction in Association with Cytomegalovirus Infection in a Renal Transplant Recipient

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