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<p>Disseminated adenovirus infection is a rare but often fatal complication of hematopoietic stem cell transplantation (HSCT), particularly uncommon in the autologous setting. We report the case of a 59-year-old man with stage IVB diffuse large B-cell lymphoma who underwent autologous HSCT after multiple lines of therapy. Following conditioning regimen, he developed persistent fever, mucositis, dysuria, and gross hematuria, with imaging showing bilateral pyelonephritis, ureteritis, and cystitis. Despite broad-spectrum antibiotics, symptoms persisted. Quantitative PCR revealed rapidly rising adenovirus viremia (&gt; 1,000,000 copies/mL), and renal biopsy demonstrated viral cytopathic changes on light microscopy together with focal segmental glomerulosclerosis (FSGS). The patient progressed to fulminant oliguric renal failure and died before dialysis could be initiated. This case highlights a rare presentation of adenovirus infection with renal involvement consistent with adenovirus-associated nephropathy and concurrent FSGS after autologous HSCT, highlighting the potential convergence of viral, neoplastic, and transplant-related mechanisms in catastrophic renal injury.</p>

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Adenovirus infection associated with focal segmental glomerulosclerosis following autologous hematopoietic stem cell transplantation

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年5月20日

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  • Yasser Isaac Arana-Escandón,
  • Paula Eliana Ramírez-Arboleda,
  • Lina María Gaviria-Jaramillo,
  • Mauricio Andrés Álzate-Arias,
  • Oliver Gerardo Perilla-Suarez,
  • María Ximena Lagos-Buitrago,
  • Joaquín Roberto Rodelo-Ceballos,
  • Mayra Alejandra Estacio,
  • Alejandra Taborda-Murillo

摘要

Disseminated adenovirus infection is a rare but often fatal complication of hematopoietic stem cell transplantation (HSCT), particularly uncommon in the autologous setting. We report the case of a 59-year-old man with stage IVB diffuse large B-cell lymphoma who underwent autologous HSCT after multiple lines of therapy. Following conditioning regimen, he developed persistent fever, mucositis, dysuria, and gross hematuria, with imaging showing bilateral pyelonephritis, ureteritis, and cystitis. Despite broad-spectrum antibiotics, symptoms persisted. Quantitative PCR revealed rapidly rising adenovirus viremia (> 1,000,000 copies/mL), and renal biopsy demonstrated viral cytopathic changes on light microscopy together with focal segmental glomerulosclerosis (FSGS). The patient progressed to fulminant oliguric renal failure and died before dialysis could be initiated. This case highlights a rare presentation of adenovirus infection with renal involvement consistent with adenovirus-associated nephropathy and concurrent FSGS after autologous HSCT, highlighting the potential convergence of viral, neoplastic, and transplant-related mechanisms in catastrophic renal injury.