Bilateral acute retinal necrosis associated with neuroinfection in patient after renal transplantation
S Szczepanik, J Brydak-Godowska, M Ciszek, D Białas, M Grzeszczyk, D Strzelecki, D Kęcik
Ann Transplant 2009; 14(1): 73-73
Available online: 2009-05-21
Background: Acute retinal necrosis (ARN) is characterized the triad of symptoms: acute vitritis, peripheral necrotizing retinitis and vasculitis in an otherwise healthy individual. We observed a case of 54 years old woman with bilateral acute retinal necrosis associated with neuroinfection. Her past medical history was renal transplantation, hypertension and aortic stenosis. Ocular complications in the transplant recipients such as cataract, hypertensive retinopathy, glaucoma or opportunistic chorioretinal infections are known. However, coexistence of ARN and neuroinfection is extremely rare.
Material/Methods: Observational case report. Biochemical tests, lumbar puncture, eye ultrasonography and MRI of the brain were performed.
Results: Blood and cerebrospinal ï¬‚uid examination revealed elevated anti-HSV IgG antibody titter. MRI T2 scan revealed inï¬‚ammatory changes in white matter of right hemisphere. Patient was treated with acyklovir, itrakonazol, metronidazol and ciproï¬‚oxacin systemically for 3 weeks. Retinal detachments were observed in both eyes.
Conclusons: Acute retinal necrosis can be the only symptom of Herpesvirus
reactivation in patients after organ transplantation.
Keywords: Immunosuppression, Kidney Transplantation, viral infections