A RARE PRESENTATION OF CYTOMEGALOVIRUS INFECTION IN A RENAL TRANSPLANT RECIPIENT: PNEUMONIA ACCOMPANIED BY AORTIC ANEURYSM INFECTION/DISSECTION

Yıl 2018, Cilt: 81 Sayı: 3, 102 - 105, 20.09.2018

Ertuğrul Erken , Mahmut Egemen Şenel Muhammed Çiftçioğlu , Ahmet Rıza Şahin Selçuk Nazik Özkan Güngör Orçun Altunören

Öz

DOI: 10.26650/IUITFD.397135

Cytomegalovirus (CMV) infection is an
important cause of morbidity and mortality among kidney transplant recipients.
Generally it is presented with a clinical picture called CMV syndrome, but it
may cause invasive tissue involvement as well. The most frequently infected
tissues are lung and gastrointestinal system tissues. Cardiovascular
involvement is rare and generally associated with atherosclerosis and
transplant artery stenosis. In this paper, we present the case of a renal
transplant recipient with aortic aneurysm infection/dissection and pneumonia
associated with CMV infection.

Anahtar Kelimeler

CMV, pneumonia, aortic aneurysm infection, dissection, renal transplantation, renal transplantation

BÖBREK NAKLİ ALICISINDA SİTOMEGALOVİRÜS ENFEKSİYONUN NADİR BİR PREZENTEASYONU: PNÖMONİ VE EŞLİK EDEN AORT ANEVRİZMA ENFEKSİYONU/DİSEKSİYONU

Öz

DOI: 10.26650/IUITFD.397135

Sitomegalovirüs (CMV) enfeksiyonu, böbrek
nakli alıcıları için önemli bir morbidite ve mortalite nedeni olabilmektedir.
Genellikle CMV sendromu olarak adlandırılan bir klinik tabloya yol açmakla
birlikte, invaziv doku tutulumuna da yol açabilmektedir. En çok tutulan
organlar akciğerler ve gastrointestinal sistemdir. Kardiyovasküler tutulum ise
nadirdir ve sıklıkla ateroskleroz ve transplant arter stenozu ile birliktedir.
Bu yazıda; böbrek nakli alıcısında CMV enfeksiyonu ile ilişkili aort
anevrizması enfeksiyonu/diseksiyonu ve eşlik eden pnömoni nedeniyle takip
ettiğimiz nadir bir olguyu sunmayı amaçladık.

Anahtar Kelimeler

CMV, pnömoni, aort anevrizması enfeksiyonu, diseksiyon, böbrek nakli

Kaynakça

• 1. Weikert BC, Blumberg EA Viral Infection after Renal Transplantation: Surveillance and Management. Clin J Am Soc Nephrol 2008;3(Suppl 2):76-86.
• 2. Pour-Reza-Gholi F, Labibi A, Farrokhi F, Nafar M, Firouzan A, Einollahi B. Signs and symptoms of cytomegalovirus disease in kidney transplant recipients. Transplant Proc 2005;37(7):3056-8.
• 3. Cordero E, Casasola C, Ecarma R, Danguilan R. Cytomegalovirus disease in kidney transplant recipients: incidence, clinical profile, and risk factors. Transplant Proc 2012;44(3):694-700.
• 4. Campbell PT, Li JS, Wall TC, O’Connor CM, Van Trigt P, Kenney RT, Melhus O, Corey GR. Cytomegalovirus pericarditis: a case series and review of the literature. Am J Med Sci. 1995; 309(4):229-34.
• 5. Magno Palmeira M, Umemura Ribeiro HY, Garcia Lira Y, Machado Jucá Neto FO, da Silva Rodrigues IA, Fernandes da Paz LN, et al. Heart failure due to cytomegalovirus myocarditis in immunocompetent young adults: a case report. BMC Res Notes 2016;5:9:391.
• 6. Landenhed M, Engström G, Gottsäter A, Caulfield MP, Hedblad B, Newton-Cheh C, Melander O, Smith JG. Risk profiles for aortic dissection and ruptured or surgically treated aneurysms: a prospective cohort study. J Am Heart Assoc 2015;21:4(1):e001513.
• 7. Choke E, Cockerill G, Wilson WR, Sayed S, Dawson J, Loftus I, et al. A review of biological factors implicated in abdominal aortic aneurysm rupture. Eur J Vasc Endovasc Surg 2005;30(3):227-44.
• 8. Gredmark-Russ S, Dzabic M, Rahbar A, Wanhainen A, Björck M, Larsson E, et al. Active cytomegalovirus infection in aortic smooth muscle cells from patients with abdominal aortic aneurysm. J Mol Med (Berl) 2009;87(4):347-56.
• 9. Arai Y, Tsuchida T, Kosugi I, Kawasaki H, Meguro S, Kinoshita M, et al. Effects of intrapulmonary viral tropism and cytokine expression on the histological patterns of cytomegalovirus pneumonia. Pathol Int 2012;62(9):628-39.
• 10. Qiu H, Strååt K, Rahbar A, Wan M, Söderberg-Nauclér C, Haeggström JZ. Human CMV infection induces 5-lipoxygenase expression and leukotriene B4 production in vascular smooth muscle cells. J Exp Med 2008;205(1):19-24.
• 11. Nyberg A, Skagius E, Nilsson I, Ljungh A, Henriksson AE. Abdominal aortic aneurysm and cytomegalovirus infection. J Med Virol 2008;80(4):667-9.
• 12. Tanaka S, Komori K, Okadome K, Sugimachi K, Mori R. Detection of active cytomegalovirus infection in inflammatory aortic aneurysms with RNA polymerase chain reaction. J Vasc Surg 1994;20(2):235-43.
• 13. Yonemitsu Y, Kaneda Y, Komori K, Hirai K, Sugimachi K, Sueishi K. The immediate early gene of human cytomegalovirus stimulates vascular smooth muscle cell proliferation in vitro and in vivo. Biochem Biophys Res Commun 1997;231(2):447-51.