A Case of Native Cytomegalovirus Pancreatitis Following Deceased-Donor Renal Transplantation

Abstract

Cytomegalovirus (CMV) is a known cause of pancreatitis in immunocompromised patients, usually in association with the human immunodeficiency virus [1]. A handful of cases have been reported of CMV pancreatitis occurring in a transplanted pancreas secondary to immunosuppression associated with organ transplantation. Herein, we report a rare case of CMV pancreatitis following deceased-donor renal transplantation in which a patient's native pancreas was infected by CMV transmitted by donor renal tissue. After seroconversion from a CMV-positive donor, a 41 year old female with a history of autosomal dominant polycystic kidney disease presented with pancreatitis in her native pancreas following deceased donor renal transplantation, thus illustrating how a patient's native pancreas can be infected by CMV from donor renal tissue.

A Practical Review of Cytomegalovirus in Gastroenterology and Hepatology

“…An autopsy study found that approximately 10% of patients with CMV infection have pancreas involvement, although selection bias of severe disease is expected [ 35 ]. Most diagnoses in case reports are based on acute pancreatitis in the setting of CMV viremia with demonstrated response to CMV treatment [ 36 – 38 ]. Cholangitis with CMV involvement of the biliary epithelium has also been reported [ 39 ].…”

Rare Presentations of Cytomegalovirus Infection in Renal Allograft Recipients

“…A study using a pathologic examination revealed ulcerations and necrosis with scattered CMV inclusions (28). Duodenal vasculitis, intermittent small-bowel obstruction, acute pancreatitis, bloody ascites, colonic obstruction, and painful hemorrhoids have been reported as rare gastrointestinal presentations of CMV infection (28-36). Rare gastrointestinal presentations of CMV infection in kidney-transplant recipients are shown in Table 2.…”