المؤلفون: Mongera N; SC Nefrologia e Dialisi-ASUITs, Azienda Sanitaria Universitaria Integrata di Trieste., Di Maso V; SC Nefrologia e Dialisi-ASUITs, Azienda Sanitaria Universitaria Integrata di Trieste., Ermacora E; SC Nefrologia e Dialisi-ASUITs, Azienda Sanitaria Universitaria Integrata di Trieste., Carraro M; SC Nefrologia e Dialisi-ASUITs, Azienda Sanitaria Universitaria Integrata di Trieste., Bregant C; SC Nefrologia e Dialisi-ASUITs, Azienda Sanitaria Universitaria Integrata di Trieste., Pian M; SC Nefrologia e Dialisi-ASUITs, Azienda Sanitaria Universitaria Integrata di Trieste., Savi U; SC Nefrologia e Dialisi-ASUITs, Azienda Sanitaria Universitaria Integrata di Trieste., Lorenzon E; SC Nefrologia e Dialisi-ASUITs, Azienda Sanitaria Universitaria Integrata di Trieste., Boscutti G; SC Nefrologia e Dialisi-ASUITs, Azienda Sanitaria Universitaria Integrata di Trieste.

المصدر: Giornale italiano di nefrologia : organo ufficiale della Societa italiana di nefrologia [G Ital Nefrol] 2018 May; Vol. 35 (3).

نوع المنشور: Case Reports

بيانات الدورية: Publisher: Società Italiana di Nefrologia Country of Publication: Italy NLM ID: 9426434 Publication Model: Print Cited Medium: Internet ISSN: 1724-5990 (Electronic) Linking ISSN: 03935590 NLM ISO Abbreviation: G Ital Nefrol Subsets: MEDLINE

مواضيع طبية MeSH: Acyclovir/*therapeutic use , Antiviral Agents/*therapeutic use , Epstein-Barr Virus Infections/*etiology , Granulomatosis with Polyangiitis/*complications , Immunosuppressive Agents/*adverse effects , Pneumonia, Viral/*etiology, Aged ; Cyclophosphamide/adverse effects ; Cyclophosphamide/therapeutic use ; Disease Susceptibility ; Dyspnea/etiology ; Epstein-Barr Virus Infections/drug therapy ; Female ; Granulomatosis with Polyangiitis/drug therapy ; Herpesvirus 4, Human/isolation & purification ; Humans ; Immunocompromised Host ; Immunosuppressive Agents/therapeutic use ; Kidney Failure, Chronic/etiology ; Kidney Failure, Chronic/therapy ; Pneumonia, Viral/drug therapy ; Pneumonia, Viral/virology ; Prednisone/adverse effects ; Prednisone/therapeutic use ; Renal Dialysis ; Respiratory Insufficiency/etiology

مستخلص: Granulomatosis polyangiitis (GPA) is an ANCA-related vasculitis (AAV) whose clinical manifestations mainly concern the respiratory tract (upper and lower) and the kidney. The treatment of GPA (as well as other AAV) includes the use of immunosuppressive drugs with numerous side effects; the most frequent complications are infectious and neoplastic. GPA frequently relapses. Epstein Barr Virus (EBV) is a ubiquitous virus; it is estimated that about 90% of the world’s population has BEEN EXPOSED TO with this pathogen and has subsequently developed a latent infection. Under certain conditions including immunosuppression EBV may reactivate. We report the clinical case of a 67-year-old woman who presented with GPA involving the upper respiratory tract and renal failure with the need for hemodialysis treatment. The fourth month of induction therapy with cyclophosphamide and methylprednisone she presented with dyspnea and respiratory failure. After excluding pulmonary embolism and heart failure, a series of investigations including high resolution tomography and fibroscopy with broncoalveolar lavage (BAL) were performed which excluded recurrence of pulmonary vasculitis including alveolar haemorrhage A BAL demonstrated EBV-DNA. On this basis EBV pneumonia was diagnosed, and antiviral therapy with acyclovir was begun, followed by clinical and radiological improvement. In patients with GPA treated with immunosuppressive drugs pulmonary involvement may not only be due to the underlying vasculitis, but also to opportunistic agents, which must always be considered.
(Copyright by Società Italiana di Nefrologia SIN, Rome, Italy.)

عنوان ترانسليتريتد: Monitoraggio della carica virale dell'EBV nei linfomonociti e nel siero di trapiantati renali mediante un protocollo di PCR quantitativa.

المؤلفون: Merlino C; Dip. Sanita' Pubblica e Microbiologia, S.C. Virologia, Universita' di Torino, Torino, Italy. chiara.merlino@unito.it, Giacchino F, Bergallo M, Bonello F, Bollero C, Segoloni GP, Cavallo R

المصدر: Giornale italiano di nefrologia : organo ufficiale della Societa italiana di nefrologia [G Ital Nefrol] 2003 Mar-Apr; Vol. 20 (2), pp. 170-5.

نوع المنشور: Evaluation Study; Journal Article

بيانات الدورية: Publisher: Società Italiana di Nefrologia Country of Publication: Italy NLM ID: 9426434 Publication Model: Print Cited Medium: Print ISSN: 0393-5590 (Print) Linking ISSN: 03935590 NLM ISO Abbreviation: G Ital Nefrol Subsets: MEDLINE

مواضيع طبية MeSH: Kidney Transplantation*, DNA, Viral/*blood , Epstein-Barr Virus Infections/*blood , Herpesvirus 4, Human/*isolation & purification , Leukocytes, Mononuclear/*virology , Lymphoproliferative Disorders/*diagnosis , Polymerase Chain Reaction/*methods , Postoperative Complications/*diagnosis , Viremia/*virology, Cyclosporine/adverse effects ; Cyclosporine/therapeutic use ; Epstein-Barr Virus Infections/virology ; Female ; Follow-Up Studies ; Humans ; Immunosuppressive Agents/adverse effects ; Immunosuppressive Agents/therapeutic use ; Lymphoproliferative Disorders/virology ; Male ; Methylprednisolone/adverse effects ; Methylprednisolone/therapeutic use ; Middle Aged ; Postoperative Complications/virology ; Predictive Value of Tests ; Sirolimus/adverse effects ; Sirolimus/therapeutic use ; Tacrolimus/adverse effects ; Tacrolimus/therapeutic use ; Viral Load

مستخلص: Background: Post-transplant lymphoproliferative disorders (PTLD), ranging from lymphoid hyperplasia to clonal malignancy, are severe complications arising in solid organ transplant patients; their reported incidence ranges from 1 to 20%, according to factors such as type of transplanted organ and age of recipients. A strong correlation between Epstein-Barrvirus (EBV) infection, the grade and type of immunosuppression and the development of PTLD has been recognized. The detection and quantification of EBV-DNA load in peripheral blood have been utilized as prognostic markers for the development of PTLD, showing a correlation between high levels of EBV-DNA in the blood and the development of PTLD. In this study, we monthly monitored EBV viral load in 15 renal transplant recipients for six months. The number of EBV-DNA copies was measured in peripheral blood mononuclear cells (PBMC) and serum samples by a quantitative PCR protocol developed in our laboratory.
Methods: Our EBV-DNA quantification protocol employs a previous screening of samples containing a significant number of viral DNA copies (>=1000 copies/105 PBMC or 100 mL serum) by semi-quantitative PCR followed by a precise quantification of the only significant samples by quantitative-competitive (QC)-PCR.
Results: Our 15 renal transplant patients neither developed PTLD nor had recurrent acute illnesses or acute graft rejections during the study. The results obtained in the monthly follow up of EB viral load in PBMC samples confirmed its fluctuation in asymptomatic patients reported in the literature. In particular, 5/14 (35.7%) of EBV seropositive patients had an EBV-DNA load equal to 1000 EBV copies /105 PBMC, and 1/14 (7.1%) reached 5000 EBV copies /105 PBMC at least once in our study. In the EBV seronegative patient, EBV-DNA in PBMC samples was always undetectable (less than 100 DNA copies/105 PBMC). EBV-DNA load in all serum samples was less than threshold value of our quantification protocol (<100 DNA copies/100 mL serum). With regard to the immunosuppressive treatment, it should be noted that 66.7% of the six patients in whom EBV load reached values equal to or higher than 1000 DNA copies/105 PBMC, were on FK506 whereas only 33.3% of them were on CyA.
Conclusions: Since the high positive predictive value of EB viral load in peripheral blood for diagnosis of PTLD reported by several Authors, and the described absence of correlation between the serological evidence of EBV reactivation and EB viral load, EBV viral load measurement in PBMC and serum samples using quantitative PCR techniques is a powerful diagnostic tool to monitor transplanted patients at risk of developing PTLD.

عنوان ترانسليتريتد: Virus erpetici e trapianto renale.

المؤلفون: Morrone LF; U.O. Nefrologia e Dialisi Policlinico di Bari. lfmorrone@wappi.com, Capurso D, D'Elia F, Di Paolo S, Grandaliano G, Marangi AL, Schena A, Stallone G, Tarantino G

مؤلفون مشاركون: Gruppo di Studio Apulo-Lucano sul Trapianto Renale

المصدر: Giornale italiano di nefrologia : organo ufficiale della Societa italiana di nefrologia [G Ital Nefrol] 2002 May-Jun; Vol. 19 (3), pp. 316-25.

نوع المنشور: English Abstract; Journal Article; Review

بيانات الدورية: Publisher: Società Italiana di Nefrologia Country of Publication: Italy NLM ID: 9426434 Publication Model: Print Cited Medium: Print ISSN: 0393-5590 (Print) Linking ISSN: 03935590 NLM ISO Abbreviation: G Ital Nefrol Subsets: MEDLINE

مواضيع طبية MeSH: Herpesviridae Infections/*etiology , Kidney Transplantation/*adverse effects, Cytomegalovirus Infections/etiology ; Epstein-Barr Virus Infections/etiology ; Humans

مستخلص: Over the last few years emerging evidence indicate the involvement of herpes viruses in the pathogenesis of several medical complications in transplanted patients. Herpes viruses are transmitted via inter-human contact and cause a primary infection, which commonly fails to give clinical signs and may persist even for years in a latent state in healthy subjects. In transplanted patients, herpes viruses may be transmitted through the transplanted organ or may be reactivated because of the use of powerful immunosuppressive drugs. Moreover, the persistence of immunosuppression greatly favours the clinical expression and severity of virus infection. Thus, herpes viruses seem to be involved in both acute and chronic deterioration of graft function, in the pathogenesis of post-transplant lymphoproliferative disorders and Kaposi sarcoma, and even in vessel atherosclerosis. This review will focus on relevant clinical aspects of herpes-virus infection, namely cytomegalovirus, EBV, herpes simplex 1 and 2, varicella zoster virus, HHV-6, HHV-7 and HHV-8, in kidney transplanted patients.