Adenovirus Fulminant Hepatic Failure: Disseminated Adenovirus Disease after Unrelated Allogeneic Stem Cell Transplantation for Acute Lymphoblastic Leukemia

Nakazawa, Hayakazu; Ito, Toshiro; Makishima, Hideki; Misawa, Noriko; Okiyama, Wataru; Uehara, Takeshi; Hidaka, Eiko; Kiyosawa, Kendo; Ishida, Fumihiro

doi:10.2169/internalmedicine.45.1699

Cited by 20 publications

(15 citation statements)

References 41 publications

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“…Despite this fact, we were unable to identify any cases of fulminant hepatitis E in the USA, nor was there evidence of parvovirus B19 in this setting [40]. Herpesviruses and adenoviruses occasionally cause ALF in the setting of intense immunosuppression [41]. Previously unrecognized hepatitis B infection is also capable of causing rapid hepatic failure with cancer chemotherapy or other forms of immunosuppression [42], but this can be prevented effectively by the use of nucleoside analogues [43].…”

Section: Viral Hepatitismentioning

confidence: 89%

Etiologies of acute liver failure

Lee

Seremba

2008

Current Opinion in Critical Care

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Section: Viral Hepatitismentioning

confidence: 89%

Etiologies of acute liver failure

Lee

Seremba

2008

Current Opinion in Critical Care

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“…As shown in Table 2, the results of imaging studies of adenovirus hepatitis after HSCT have been described in 3 patients. One of the 3 patients showed diffuse nonspecific changes by ultrasound and magnetic resonance scans of the liver (12), while the other 2 showed no abnormality (13,14). With regard to solid organ transplantation recipients, Gupta et al…”

Section: Discussionmentioning

confidence: 99%

Fulminant Hepatic Failure Caused by Adenovirus Infection Mimicking Peliosis Hepatitis on Abdominal Computed Tomography Images after Allogeneic Hematopoietic Stem Cell Transplantation

et al. 2012

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Disseminated adenovirus disease after allogeneic hematopoietic stem cell transplantation (HSCT) is lethal in most cases, especially when it develops as fulminant hepatic failure. We encountered a patient who developed fulminant hepatic failure caused by adenovirus infection. She did not show manifestations of graftversus-host disease and the results of serum tests for viral infection were all negative. Abdominal computed tomography (CT) findings were consistent with peliosis hepatitis. She died of fulminant hepatic failure, however, and pathological examinations of the liver specimen obtained after her death revealed adenovirus infection. In this report, we review the clinical characteristics and imaging findings of fulminant hepatic failure caused by adenovirus infection.

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“…These results indicate that most of the HAdV DNA detected in the liver biopsy (7.0 Â 10 2 copies/cell) was not blood borne virus but result of focal, replicative HAdV infection of the liver parenchyma. So far, antemortem diagnosis of HAdV associated liver failure in SCT patients by biopsy has been reported only twice [Nakazawa et al, 2006], and this is the first description of HAdV DNA concentration and distribution in a liver biopsy of a SCT patient.…”

Section: Case Reportmentioning

confidence: 83%

“…Eventually, overwhelming HAdV infection of the liver caused fulminant liver failure. Infections with HAdV type 2, which are frequently associated with immunosuppression [Madisch et al, 2006] and life threatening disseminated disease, present only infrequently as fulminant hepatitis or ''hepatic failure'' [Chakrabarti et al, 1999;Nakazawa et al, 2006]. However, occasional cases of fulminant HAdV replication in the liver may be missed by conventional histopathology in leucopenic SCT patients due to absence of inflammatory infiltration.…”

Section: Discussionmentioning

confidence: 99%

Quantitative temporal and spatial distribution of adenovirus type 2 correlates with disease manifestations and organ failure during disseminated infection

Forstmeyer

Henke-Gendo

Bröcker

et al. 2007

Journal of Medical Virology

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Disseminated adenovirus (HAdV) infections are serious complications in allogenic stem cell transplant (SCT) recipients. Quantitative HAdV DNA detection in blood samples demonstrated the association of high virus loads with disease and improved early diagnosis. However, the pathogenesis of disseminated HAdV disease, for example sources of HAdV DNA shedding in the blood stream and association of HAdV replication sites with disease manifestations, remained obscure. In this report, 24 bioptic and autoptic organ and tissue samples of an adult SCT recipient suffering from disseminated infection were quantitatively analyzed for HAdV DNA. Results indicate subsequent virus replication in the colon, bone marrow and liver as origin of HAdV DNAemia, which increased from 1.4 x 10(4) copies/ml to a peak of 2 x 10(9) copies/ml over a period of 84 days in spite of antiviral therapy. Symptoms as diarrhoea, bone marrow failure and hepatic failure were clearly linked to high HAdV DNA concentrations in affected organs. For example, the HAdV DNA level was 2.2 x 10(3) copies/cell in a colon biopsy when the patient suffered from diarrhoea whereas only 1.1 x 10(1) copies/cell were detected when symptoms had improved. Focal HAdV infection of the liver as demonstrated by laser microdissection was followed by fulminant virus replication with 1.3 x 10(5) copies of HAdV DNA/cell causing terminal hepatic failure. In conclusion, pathogenesis of disseminated HAdV disease was associated with virus replication in affected organs and not immune mediated as suggested recently by a fatal case of gene therapy with a non-replication competent HAdV-C5 vector.

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Adenovirus Fulminant Hepatic Failure: Disseminated Adenovirus Disease after Unrelated Allogeneic Stem Cell Transplantation for Acute Lymphoblastic Leukemia

Abstract: Abstract

Cited by 20 publications

References 41 publications

Etiologies of acute liver failure

Etiologies of acute liver failure

Fulminant Hepatic Failure Caused by Adenovirus Infection Mimicking Peliosis Hepatitis on Abdominal Computed Tomography Images after Allogeneic Hematopoietic Stem Cell Transplantation

Quantitative temporal and spatial distribution of adenovirus type 2 correlates with disease manifestations and organ failure during disseminated infection

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