Saad R S, Demetris A J, Lee R G, Kusne S, Randhawa P S
Department of Pathology, University of Pittsburgh Medical Center, Pennsylvania 15213, USA.
Transplantation. 1997 Nov 27;64(10):1483-5. doi: 10.1097/00007890-199711270-00021.
Adenovirus hepatitis in the allograft liver is an uncommon condition hitherto recognized only in pediatric patients. We describe two adult cases.
Clinical information was obtained by reviewing the medical records. The diagnosis of adenoviral infection was made by immunohistochemistry or culture.
Both patients had received recent antirejection treatment and presented with fever, hepatic dysfunction, and progressive leukopenia. One patient had some viral inclusions resembling those described in herpes simplex infections. Adenovirus was cultured from the liver in both cases and from the lung in one case. Both patients were treated by decreasing the immunosuppression and intravenous acyclovir, but died.
Adenovirus infection should be considered when evaluating adult liver transplant patients with necrotizing lesions or microabscess formation at allograft biopsy. A review of the literature shows that most previously reported infections have led to graft loss or death, but occasional remissions of disease are also on record.
同种异体移植肝中的腺病毒肝炎是一种罕见病症，迄今仅在儿科患者中得到确认。我们描述了两例成人病例。
通过查阅病历获取临床信息。腺病毒感染的诊断通过免疫组织化学或培养来进行。
两名患者近期均接受了抗排斥治疗，表现为发热、肝功能障碍和进行性白细胞减少。一名患者出现了一些类似于单纯疱疹感染中所描述的病毒包涵体。两例患者的肝脏均培养出腺病毒，其中一例患者的肺部也培养出腺病毒。两名患者均接受了降低免疫抑制和静脉注射阿昔洛韦的治疗，但均死亡。
在评估成人肝移植患者移植活检出现坏死性病变或微脓肿形成时，应考虑腺病毒感染。文献回顾表明，之前报道的大多数感染都导致了移植物丢失或死亡，但也有疾病偶尔缓解的记录。
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