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Transplant renal artery stenosis associated with acute cytomegalovirus infection: resolution following ganciclovir administration.

Abstract
Cytomegalovirus has been implicated in the pathogenesis of transplant renal artery stenosis. However, the clinical course of this infection-associated transplant renal artery stenosis and its response to antiviral treatment is still unclear. We report a patient with transplant renal artery stenosis associated with an acute cytomegalovirus infection, which resolved following ganciclovir administration without the need for surgical or angiographic intervention. Serological testing revealed positive titers of anti- cytomegalovirus IgM and IgG antibodies. Renal allograft Doppler study findings were compatible with critical renal artery stenosis. Renal allograft angiography disclosed a critical circular stenosis. Following the intravenous ganciclovir administration, dramatically decreased Doppler ultrasound parameters along with the absence of parvus/tardus waveform pattern revealed the resolution of the stenosis. Moreover, the serological testing was negative for anti-cytomegalovirus IgM antibody, but anti-cytomegalovirus IgG antibody was positive. This report not only implies the causative possible relationship between acute cytomegalovirus infection and transplant renal artery stenosis, but it also highlights the importance of this complication when managing a renal transplant recipient with signs of allograft arterial stenosis.
AuthorsMohammad R Ardalan, Mohammadali M Shoja, R Shane Tubbs, Kamyar Ghabili
JournalRenal failure (Ren Fail) Vol. 31 Issue 10 Pg. 982-4 ( 2009) ISSN: 1525-6049 [Electronic] England
PMID20030536 (Publication Type: Case Reports, Journal Article)
Chemical References
  • Antibodies, Viral
  • Antiviral Agents
  • Immunoglobulin G
  • Immunoglobulin M
  • Ganciclovir
Topics
  • Adult
  • Antibodies, Viral (blood)
  • Antiviral Agents (therapeutic use)
  • Cytomegalovirus Infections (complications, drug therapy)
  • Female
  • Ganciclovir (therapeutic use)
  • Humans
  • Immunoglobulin G (blood)
  • Immunoglobulin M (blood)
  • Kidney Transplantation (adverse effects)
  • Renal Artery Obstruction (drug therapy, virology)

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