[Acute necrotizing tubulointerstitial nephritis due to adenoviral infection following hematopoietic stem cell transplantation: clinical findings obtained from 4 autopsy cases].

Once adenovirus infection extends to the kidney from the bladder in the immunosuppressive state after hematopoietic stem cell transplantation, most patients develop acute renal failure due to adenovirus-associated necrotizing tubulointerstitial nephritis. In the 6 years from 2000 to 2006, we retrospectively investigated the characteristics of adenovirus infection in 402 patients who had received a hematopoietic stem cell transplantation in our hospital. The incidence of adenovirus-associated hemorrhagic cystitis in patients who had received a hematopoietic stem cell transplantation was 3.5% (14/402). Among these 14 patients, 4 developed acute necrotizing tubulointerstitial nephritis all of whom died, which yielded the incidence and mortality rates of the disease of 1.0% and 100%, respectively. Once adenovirus infection extends to major organs in a rapid manner, the patient's general condition becomes fatal. Further study is necessary to establish the diagnosis and treatment of adenoviral infections in a compromised host.