A case of severe nephrotic syndrome caused by isolated CMV glomerulopathy with ganciclovir resistant UL 97 mutation

Ramez R. Sunna; Rupinder Sodhi; Francis Arden Purvis; Rosemary Ouseph; David S. Brink; Bahar Bastani

doi:10.15171/jnp.2019.41

J Nephropathol. 2019;8(4): e41.
doi: 10.15171/jnp.2019.41

Scopus ID: 85074970902

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Original Article

A case of severe nephrotic syndrome caused by isolated CMV glomerulopathy with ganciclovir resistant UL 97 mutation

Ramez R. Sunna ¹, Rupinder Sodhi ¹, Francis Arden Purvis ², Rosemary Ouseph ¹, David S. Brink ³, Bahar Bastani ¹^*

¹ Department of Internal Medicine, Division of Nephrology, Saint Louis University School of Medicine, Saint Louis, Missouri, USA
² Transplant Institute, Saint Louis University School of Medicine, Saint Louis, Missouri, USA
³ Department of Pathology, Saint Louis University School of Medicine, Saint Louis, Missouri, USA

*Corresponding Author: Email:

Abstract

Introduction: While many cases of cytomegalovirus (CMV) nephropathy have been reported in the literature, isolated CMV glomerulopathy is considered a rare finding.

Case Presentation: We report the case of a CMV-negative recipient of kidney allograft from a CMVpositive donor (D+/R-), the recipient subsequently developed severe nephrotic syndrome secondary to biopsy-proven isolated CMV glomerulopathy.

Conclusion: The patient developed CMV viremia with ganciclovir resistant UL97 mutation. His treatment course was resistant to recommended dose of intravenous ganciclovir, so therapy was changed to foscarnet with resolution of his viremia and reduction in proteinuria.

Keywords: CMV glomerulopathy, CMV viremia, kidney transplant, UL 97 mutation, nephrotic syndrome, proteinuria

Implication for health policy/practice/research/medical education:

Clinicians need to be aware of CMV complications in the kidney transplant population.

Please cite this paper as: Sunna RR, Sodhi R, Purvis FA, Ouseph R, Brink DS, Bastani B. A case of severe nephrotic syndrome caused by isolated CMV glomerulopathy with ganciclovir resistant UL 97 mutation. J Nephropathol. 2019;8(4):e41. DOI: 10.15171/jnp.2019.41.