Raboni S M, Siqueira M M, Portes S R, Pasquini R
Laboratory of Virology, Hospital de Clínicas da Universidade Federal do Paraná, R. Padre Camargo, C.E.P 82060-240, Alto da XV, Curitiba, PR, Brazil.
J Clin Virol. 2003 Aug;27(3):270-5. doi: 10.1016/s1386-6532(02)00182-8.
Adenovirus-associated hemorrhagic cystitis (HC) has become a recognized sequel of immunosuppression. The diagnosis of viral infection is usually determined by viral cultures.
Analysis of different diagnostic methods for adenovirus (AdV) detection in bone marrow transplant patients with hemorrhagic cystitis.
We describe a prospective study for AdV detection in the urine of patients with hematuria in the first 100 days after bone marrow transplant (BMT), comparing different laboratory techniques, PCR, enzyme immunoassay (EIA) and conventional culture.
A total of 143 urine samples were analyzed, 75 collected in the pre-transplant period with and without hematuria and 68 post-transplant, only with microscopic or macroscopic hematuria. After BMT, hematuria occurred in 38.9% of patients, being more frequent in unrelated donor transplants. AdV was isolated in one pre-transplant patient without symptoms and in three post-transplant patients with HC grades 3 and 4 (severe), who were in month 2 or 3 post-transplant. Compared to culture as the gold standard, the accuracy, specificity and sensitivity of EIA were 95, 30 and 100% and for PCR were 63, 100 and 60%, respectively.
We concluded that despite technical difficulties and the long time that elapsed before results were obtained, cell culture still remains the best method for adenovirus detection in the urine of patients with hemorrhagic cystitis.
腺病毒相关性出血性膀胱炎（HC）已成为免疫抑制的一种公认后遗症。病毒感染的诊断通常通过病毒培养来确定。
分析骨髓移植后出血性膀胱炎患者腺病毒（AdV）检测的不同诊断方法。
我们描述了一项对骨髓移植（BMT）后前100天内血尿患者尿液中AdV检测的前瞻性研究，比较了不同的实验室技术，即聚合酶链反应（PCR）、酶免疫测定（EIA）和传统培养法。
共分析了143份尿液样本，75份在移植前采集，包括有血尿和无血尿的情况，68份在移植后采集，仅伴有镜下或肉眼血尿。BMT后，38.9%的患者出现血尿，在无关供体移植中更常见。在1例移植前无症状的患者以及3例移植后2或3个月出现3级和4级（重度）HC的患者中分离出AdV。与作为金标准的培养法相比，EIA的准确性、特异性和敏感性分别为95%、30%和100%，PCR的分别为63%、100%和60%。
我们得出结论，尽管存在技术困难且结果获取时间较长，但细胞培养仍然是出血性膀胱炎患者尿液中腺病毒检测的最佳方法。
