Journal article
Acute kidney injury in symptomatic primary Epstein-Barr virus infectious mononucleosis: Systematic review.
- Moretti M Pediatric Department of Southern Switzerland, Bellinzona, Switzerland.
- Lava SAG University Children's Hospital Bern and University of Bern, Switzerland; Pediatric Pharmacology and Pharmacogenetics, Hôpital Robert Debré, Paris, France. Electronic address: sebastiano.lava@bluewin.ch.
- Zgraggen L Pediatric Department of Southern Switzerland, Bellinzona, Switzerland; University Children's Hospital Bern and University of Bern, Switzerland.
- Simonetti GD Pediatric Department of Southern Switzerland, Bellinzona, Switzerland; Università della Svizzera Italiana, Lugano, Switzerland.
- Kottanattu L Pediatric Department of Southern Switzerland, Bellinzona, Switzerland.
- Bianchetti MG Pediatric Department of Southern Switzerland, Bellinzona, Switzerland; Università della Svizzera Italiana, Lugano, Switzerland.
- Milani GP Pediatric Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico and Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy.
- 2017-04-15
Published in:
- Journal of clinical virology : the official publication of the Pan American Society for Clinical Virology. - 2017
Acute kidney injury
Epstein-Barr virus infections
Hemolytic-uremic syndrome
Interstitial
Myositis
Nephritis
Acute Kidney Injury
Adult
Epstein-Barr Virus Infections
Female
Herpesvirus 4, Human
Humans
Infectious Mononucleosis
Male
Myositis
Nephritis, Interstitial
English
BACKGROUND AND OBJECTIVES
Textbooks and reviews do not mention the association of symptomatic primary Epstein-Barr virus infectious mononucleosis with acute kidney injury in subjects without immunodeficiency or autoimmunity.
STUDY DESIGN
Stimulated by our experience with two cases, we performed a review of the literature.
RESULTS
The literature documents 38 cases (26 male and 12 female individuals ranging in age from 0.3 to 51, median 18 years) of symptomatic primary Epstein-Barr virus infectious mononucleosis complicated by acute kidney injury: 27 acute interstitial nephritides, 1 jaundice-associated nephropathy, 7 myositides and 3 hemolytic uremic syndromes. Acute kidney injury requiring renal replacement therapy was observed in 18 (47%) cases. Acute kidney injury did not resolve in one patient with acute interstitial nephritis. Two patients died because of systemic complications. The remaining 35 cases fully recovered.
CONCLUSIONS
In individuals with acute symptomatic Epstein-Barr virus infectious mononucleosis, a relevant kidney injury is rare but the outcome potentially fatal. It results from interstitial nephritis, myositis-associated acute kidney injury, hemolytic uremic syndrome or jaundice-associated nephropathy.
Textbooks and reviews do not mention the association of symptomatic primary Epstein-Barr virus infectious mononucleosis with acute kidney injury in subjects without immunodeficiency or autoimmunity.
STUDY DESIGN
Stimulated by our experience with two cases, we performed a review of the literature.
RESULTS
The literature documents 38 cases (26 male and 12 female individuals ranging in age from 0.3 to 51, median 18 years) of symptomatic primary Epstein-Barr virus infectious mononucleosis complicated by acute kidney injury: 27 acute interstitial nephritides, 1 jaundice-associated nephropathy, 7 myositides and 3 hemolytic uremic syndromes. Acute kidney injury requiring renal replacement therapy was observed in 18 (47%) cases. Acute kidney injury did not resolve in one patient with acute interstitial nephritis. Two patients died because of systemic complications. The remaining 35 cases fully recovered.
CONCLUSIONS
In individuals with acute symptomatic Epstein-Barr virus infectious mononucleosis, a relevant kidney injury is rare but the outcome potentially fatal. It results from interstitial nephritis, myositis-associated acute kidney injury, hemolytic uremic syndrome or jaundice-associated nephropathy.
- Language
-
- English
- Open access status
- closed
- Identifiers
-
- DOI 10.1016/j.jcv.2017.03.016
- PMID 28410496
- Persistent URL
- https://sonar.ch/global/documents/140330
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