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肾移植后BK病毒肾病合并脑膜脑炎

BK virus nephropathy complicated with meningoencephalitis after kidney transplantation.

作者信息

Rocha Ana, Faria Sameiro, Costa Teresa, Marques Laura, Freitas Cristina, Mota Conceição

机构信息

Department of Pediatric Nephrology, Centro Hospitalar do Porto, Largo Professor Abel Salazar, Porto, Portugal.

出版信息

Pediatr Transplant. 2014 Mar;18(2):E48-51. doi: 10.1111/petr.12209. Epub 2013 Dec 16.

Abstract

BK disease is an opportunistic infection in organ transplant recipients and patients with other cellular immunodeficiencies. To the best of our knowledge, we report the second case of BK meningoencephalitis associated with nephropathy in a kidney transplant recipient. A 15-yr-old boy underwent a cadaveric kidney transplant without complications; however, 11 wk after the transplantation, he was admitted to the hospital for graft dysfunction and cytopenia, which were confirmed by BK nephropathy (plasma viral replication and histological evidence). Four days after his hospital admission, he developed a high-grade fever and headache. CSF analysis revealed pleocytosis with a positive PCR for BK virus. Reduction in immunosuppression and supportive care conducting cycles of immunoglobulin and cidofovir were successful in treating the patient. BK meningoencephalitis should be considered in kidney transplant recipients who present with signs and symptoms of meningoencephalitis.

摘要

BK 病是器官移植受者及其他细胞免疫缺陷患者的一种机会性感染。据我们所知,我们报告了第二例肾移植受者中与肾病相关的 BK 脑膜脑炎病例。一名 15 岁男孩接受了尸体肾移植,术后无并发症;然而,移植后 11 周,他因移植肾功能障碍和血细胞减少症入院,经 BK 肾病确诊(血浆病毒复制及组织学证据)。入院四天后,他出现高热和头痛。脑脊液分析显示有细胞增多,BK 病毒聚合酶链反应呈阳性。减少免疫抑制并进行免疫球蛋白和西多福韦的支持治疗周期成功治愈了该患者。对于出现脑膜脑炎体征和症状的肾移植受者,应考虑 BK 脑膜脑炎。

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