An Unusual Etiology of Viral Hepatitis in Three Renal Transplant Recipients with Normal Graft Function

Camelia Ionescu1, Gener Ismail1, Ileana Constantinescu2, Monica Hortopan3, Olguta Iliescu1, Mihaela Rosu1, Mihai Voiculescu1

Department of Internal Medicine – Nephrology1, Virusology2 and Pathology3, “Fundeni” Institute, Bucharest

Abstract

Liver impairment in renal transplant recipients is not a common complication and is associated, in most cases, with viral infections (HBV, HCV, HVD, HGV) or drug hepatotoxicity (Cyclosporin, Azathioprine, statins). Cytomegalovirus (CMV) infection is common, with 50 to 80% of the adult population being seropositive for CMV antibodies. In immunocompetent individuals, primary infection is usually asymptomatic or associated with minor illness. CMV remains latent after primary infection. In immunocompromised patients, as in renal transplant recipients or transplant recipients of other solid organ or bone marrow, the virus can cause serious disease. This could be the result of newly acquired infection or reactivation of the latent virus. One of the organs involved in CMV disease is the liver. The subjects of this report are renal transplant recipients with liver impairment due to CMV induced acute hepatitis.

Key words

Renal transplantation - liver impairment - acute viral hepatitis – cytomegalovirus