ASN2011: CPC- Adenovirus Nephropathy

One of the highlights of ASN is always the CPC conference. This year the case was a transplant case with viral nephropathy and the nephropathy was Adenoviral origin.

Adenovirus nephropathy

Adenovirus is an important virus to consider in the differential of post kidney and BMT transplant nephropathies.  The urinary subgroup is 34 or 35 and the incidence is < 1% causing nephropathy.

Can see hematuria, testicular tenderness, and subjective complaints.

The kidney biopsy usually has ATN or AIN or abscess.  The viral particles are mostly in the epithelial cells unlike CMV which can infect endothelium and epithelium.  In the EM, there are 70nm non enveloped bodies noted.

Treatment is decreasing immunosuppresion or cidofivir ( nephrotoxic) but may have to be used.

A diagnosis that we should keep in mind when thinking of viral etiologies of nephropathies post transplant. 

Take a look at this recent JASN article.

Ref:

http://www.ncbi.nlm.nih.gov/pubmed/21436288