To investigate CMV disease and its clinical presentations in allograft kidney transplant recipients. The existing data of the latest 100 kidney recipients with confirmed CMV infection up to 2002 at Shaheed Labbafinejad medical center were studied. CMV infection and disease status was reviewed and all information including demographic characteristics, past history, signs, and symptoms were obtained using their records.
The main presentations were fever in 71% of the patients, leukocytosis in 22%, leukopenia in 21%, serum creatinine rise in 74%, increased SGOT in 15%, increased SGPT in 19%, increased alkaline phosphatase in 24%, thrombocytopenia in 11%, nausea in 32%, and vomiting in 26%. Tissue involvement was relatively rare, but 6 patients had pneumonia, 2 had conjunctivitis, and 1 had vascular dermatitis. Pulmonary symptoms were observed in 20% of the cases, arthralgia in 10%, and abnormal heart sound in 7%. Four and seven percents of the patients had received intravenous and oral ganciclovir prophylaxis, respectively. Fever was associated with hospitalization time (p=0.006), increased creatinine ( p=0.006), nausea (p=0.017), vomiting (p=0.031), and post-transplantation infections (p<0.001). Also, fever was present in all patients with conjunctivitis, pneumonia, pulmonary symptoms, abnormal heart sound, in almost all with arthralgia, nausea, and vomiting, and in 63 out of 89 patients without ganciclovir prophylaxis. CMV disease in kidney recipients may present with fever, abnormal liver function tests, and serum creatinine increase, of those fever is associated with a more serious disease. Our findings showed that leukocytosis should be considered as much as leukopenia when CMV disease is suspected. However, in contrast to bone marrow transplant, CMV induced pneumonia seems not to be common. Other tissue invasive complications are even rare.