尿路ウイルス感染と拒絶反応を合併した腎移植症例

RENAL ALLOGRAFT REJECTION ASSOCIATED WITH URINARY TRACT INFECTION CAUSED BY ADENOVIRUS AFTER RENAL TRANSPLANTATION

　34歳，男性．生体腎移植術後152日目に頭痛，嘔吐，発熱を主訴にて入院．第3病日右副睾丸の腫大圧痛，前立腺圧痛，第4病日に肉眼的血尿，膀胱刺激症状が出現した．血清クレアチニン値が上昇したがパルス療法にて軽快した．尿中よりアデノウイルス11型が分離され，アデノウイルス抗体価が32倍と高く，本症例はアデノウイルスによる出血性膀胱炎，副睾丸炎，前立腺炎に拒絶反応を合併した症例であると診断した．

On the 152nd day after renal transplantation a 34-year-old male developed headache, vomiting and fever for which was administered antibiotics and γ-globline with the diagnosis of prostatitis and epididymitis. Al-though his fever tended to decline, macroscopic hematuria appeared and hemorrhagic cystitis was diagnosed. On the 160th day the serum Cr level rose (maximum 3. 4) so that he was given predonisolone pulse therapy. On the 168th day clinical symptoms disappeared and the serum Cr level recovered to its former level (1. 8). Adenovirus type 11 was isolated from his urine, with a rise in the serum titer against adenovirus.