Acute kidney injury in symptomatic primary Epstein-Barr virus infectious mononucleosis: Systematic review

作者：Moretti Milena; Lava Sebastiano A G^*; Zgraggen Lorenzo; Simonetti Giacomo D; Kottanattu Lisa; Bianchetti Mario G; Milani Gregorio P

来源：Journal of Clinical Virology, 2017, 91: 12-17.

DOI：10.1016/j.jcv.2017.03.016

• Acute kidney injury
• Epstein-Barr virus infections
• Hemolytic-uremic syndrome
• Myositis
• Nephritis
• Interstitial

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.

• 出版日期2017-6