[Cytomegalovirus infection in kidney transplant recipients in Santariskes Clinics of Vilnius University Hospital]. / Ligoniu, kuriems persodintas inkstas, citomegalovirusines infekcijos analize Vilniaus universiteto ligonines Santariskiu klinikose.

Between January 2000 and December 2006, 318 kidney transplants were performed in our unit. Cytomegalovirus infection in transplanted patients causes both direct and indirect effects on other organ systems, including acute allograft rejection and decreased graft and patient survival. The aim of our study was to evaluate the incidence of cytomegalovirus infection after kidney transplantation, the treatment strategies, and the impact of cytomegalovirus infection on allograft function and survival. Those patients who at least once were treated for cytomegalovirus infection were assigned to the study group (n=102). The control group included the remaining patients (n=216) in whom kidney transplantation was performed between January 2000 and December 2006. The mean age of the recipients in both groups was 39.8+/-12.8 years (range 15-60) and 38.5+/-12.6 years (range 7-66), respectively; retransplantations and acute allograft rejections were more common in the group treated for cytomegalovirus infection: 13 (12.7%) vs. 18 (8.3%) and 55 (53.9%) vs. 103 (47.2%), respectively. Between January 2000 and December 2006, the total number of cytomegalovirus infection episodes was 167. The greatest number of cytomegalovirus infection episodes occurred during the first 1-3 months after transplantation and accounted for 27.5%; during 3-6 months, 17.4%; during 6-12 months, 18.6%. Serum creatinine levels were higher in our study group. Cytomegalovirus infection manifested as pneumonitis in 26.5% and as gastrointestinal tract disorders in 9.8% of cases; 3.9% of patients were treated for encephalitis. Patients in the study group reported more frequently other infections: bacterial infections, 66 (64.7%) vs. 116 (53.7%); virus infections, 2 (2%) vs. 3 (1.4%); and mixed bacterial-virus infections, 8 (7.8%) vs. 4 (1.9%). The number of patients who did not experience any infection was higher in control group: 26 (25.5%) vs. 93 (43.1%). Death from cytomegalovirus infection occurred in 15 (14.7%) of the 102 patients in the study group.

[Potential causes of antigenemia in the patients with an immune complex-mediated membranoproliferative glomerulonephritis in Lithuania]. / Galimos imunokompleksinio membranoproliferacinio glomerulonefrito antigenemijos priezastys Lietuvoje.

UNLABELLED: The pathogenesis of an immune complex-mediated membranoproliferative glomerulonephritis (IMPGN) involves persistent deposition of circulating immune complexes in the glomeruli caused by persistent antigenemia. We have previously reported relatively high incidence of IMPGN in Lithuania. The objective of our study was to evaluate potential causes of persistent antigenemia in the patients with IMPGN. MATERIAL AND METHODS: Forty-five patients with IMPGN diagnosed on renal biopsy during 2000-2002 were retrospectively evaluated for the presence of persistent bacterial or viral infections, autoimmune diseases and other associated medical conditions. Patients with established diagnosis of systemic lupus erythematosus (SLE) before the biopsy were not included in the study. RESULTS: A great majority (20; 44%) of the patients were found to have persistent bacterial infections of various localization. Four patients (9%) were infected with hepatitis B virus (HBV). Three (7%) patients were eventually diagnosed with SLE and another 3 (7%) had other associated pathology. In the remaining 15 (33%) patients, IMPGN remained idiopathic. Testing for hepatitis C virus (HCV) antibody was performed in 36 patients (12 of them with idiopathic IMPGN) and was negative in all patients. Testing for HCV RNA was not performed. Patients with bacterial infections were significantly younger compared to the group of idiopathic IMPGN (36.5+/-19.1 and 53.8+/-16.4, respectively, p=0.01). We conclude that persistent bacterial infection was a major potential source of antigenemia in our patients with IMPGN, particularly in the younger patients, while HBV and HCV infection was rarely detected.