Turno-Kręcicka A, Boratyńska M, Tomczyk-Socha M, Mazanowska O
Department of Ophthalmology, Wroclaw Medical University, Wroclaw, Poland.
Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, Wroclaw, Poland.
Transpl Infect Dis. 2015 Jun;17(3):400-5. doi: 10.1111/tid.12386. Epub 2015 May 26.
Ocular complications in patients who underwent renal transplantation are attributed to side effects of the immunosuppressive regimen. Progressive outer retinal necrosis (PORN) syndrome is a clinical variant of necrotizing herpetic retinopathy and it occurs almost exclusively in patients with acquired immunodeficiency syndrome. We present a case of a human immunodeficiency virus-negative patient who underwent renal transplant and, after a few years, developed bilateral PORN associated with viral infections. Varicella zoster virus (VZV) and BK virus were identified by polymerase chain reaction from the vitreous fluid. It is unclear which of the viruses identified had the dominant role in the pathogenesis of PORN and other organ damage, or whether their actions were synergistic. Adequate antiviral immune surveillance, as well as pre-transplant vaccination against VZV, may reduce the incidence of VZV infection and its complications.
接受肾移植患者的眼部并发症归因于免疫抑制方案的副作用。进行性外层视网膜坏死（PORN）综合征是坏死性疱疹性视网膜病变的一种临床变体，几乎仅发生于获得性免疫缺陷综合征患者。我们报告一例人类免疫缺陷病毒阴性患者，该患者接受肾移植后数年，出现与病毒感染相关的双侧PORN。通过聚合酶链反应从玻璃体液中鉴定出水痘带状疱疹病毒（VZV）和BK病毒。目前尚不清楚所鉴定出的病毒中哪种在PORN及其他器官损伤的发病机制中起主导作用，或者它们的作用是否具有协同性。充分的抗病毒免疫监测以及移植前接种VZV疫苗，可能会降低VZV感染及其并发症的发生率。
