Viremia and viruria of trichodysplasia spinulosa-associated polyomavirus before the development of clinical disease in a kidney transplant recipient.
Aged
DNA, Viral
Female
Hair Diseases
/ drug therapy
Humans
Immunosuppression Therapy
/ adverse effects
Immunosuppressive Agents
Kidney
/ pathology
Kidney Transplantation
/ adverse effects
Polyomavirus Infections
/ diagnosis
Retrospective Studies
Skin
/ pathology
Transplant Recipients
Viremia
/ diagnosis
kidney transplant
polyomavirus
trichodysplasia spinulosa
viremia
viruria
Journal
Transplant infectious disease : an official journal of the Transplantation Society
ISSN: 1399-3062
Titre abrégé: Transpl Infect Dis
Pays: Denmark
ID NLM: 100883688
Informations de publication
Date de publication:
Aug 2019
Aug 2019
Historique:
received:
27
12
2018
revised:
13
04
2019
accepted:
12
05
2019
pubmed:
25
6
2019
medline:
18
12
2019
entrez:
25
6
2019
Statut:
ppublish
Résumé
Trichodysplasia spinulosa (TS) is a rare disease associated with immunosuppression and induced by a polyomavirus denominated Tricodisplasia Polyomavirus (TSPyV). We report a case of TS 6 months after kidney transplantation in a 65 years-old woman under immunosuppression therapy with prednisone, mycophenolate and tacrolimus. The patient developed follicular papules on the face with a thickening of the skin and alopecia of the eyebrows, leading to distortion of the face and a leonine appearance characteristic of the disease. The skin biopsy confirmed the clinical diagnosis and the presence of TSPyV DNA in the skin was detected. Staining for SV40 was positive. Immunosuppression was changed: mycophenolate was withdrawn, tacrolimus reduced and everolimus added. Intravenous cidofovir and later on leflunomide were added. Although the literature has reported clinical success with topical cidofovir, we were unable to use it because this drug is not available. There was an improvement of skin lesions and on cosmetic appearance. The patient had three rejections (one clinically diagnosed and two other biopsy proven), progressed with renal failure and graft loss. Retrospective analysis of stored urine and blood samples detected TSPyV DNA in some of those samples two months before the TS clinical development. This case highlights the TSPyV detection in blood and urine samples before the development of skin lesions.
Substances chimiques
DNA, Viral
0
Immunosuppressive Agents
0
Types de publication
Case Reports
Langues
eng
Sous-ensembles de citation
IM
Pagination
e13133Informations de copyright
© 2019 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Références
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