Fatal disseminated adenovirus infection in a young adult with systemic lupus erythematosus
Fatal disseminated adenovirus infection in a young adult with systemic lupus erythematosus
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DOI：
10.1016/j.jcv.2010.09.021
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发表时间：
2011-01-01
影响因子：
8.8
通讯作者：
Hodinka, Richard L.
中科院分区：
文献类型：
--
作者：
Kajon, Adriana E.;Dickson, Laura M.;Hodinka, Richard L.
背景：皮质类固醇和其他免疫抑制剂的使用增加了系统性红斑狼疮（SLE）患者感染的风险。人类腺病毒（hav）在这些患者急性病毒性疾病病因学中的作用尚不清楚。目的：描述一例接受免疫抑制治疗的SLE患者急性致死性弥散性腺病毒感染。研究设计：通过实时PCR进行病例报告和详细的病毒诊断，通过六邻体和纤维基因测序以及病毒DNA的限制性内切酶分析对病毒分离物进行分子分型。结果：在呼吸道、尿液、血浆、滑液、脑脊液等多种临床标本中检测到甲型肝炎病毒。对六邻体和纤维基因的扩增和序列分析表明，该病毒在两个编码区均为hadv -7样。从呼吸道和尿液标本中分离到的腺病毒DNA的限制性内切酶分析结果表明，腺病毒完全相同，符合基因组型7d2。分离的菌株编码一个独特的纤维基因，该基因缺失6个核苷酸，对应于旋叶区250和251个氨基酸位置，这是先前未在HAdV-7密切相关的基因组变体中描述的。结论：应将腺病毒检测纳入SLE患者发热和/或呼吸道症状的诊断检测中。(C) 2010年Elsevier B.V.出版
Background: The use of corticosteroids and other immunosuppressive agents increases the risk of infection in patients with systemic lupus erythematosus (SLE). The role of human adenoviruses (HAdV) in the etiology of acute viral diseases in these patients is not known.Objectives: Describe a case of acute fatal disseminated adenovirus infection in an SLE patient receiving immunosuppressive therapy.Study design: Case report and detailed viral diagnosis by real time PCR and molecular typing of virus isolates by sequencing of hexon and fiber genes and restriction enzyme analysis of viral DNA.Results: HAdV was detected by real time PCR in multiple clinical specimens including respiratory, urine, plasma, synovial fluid, and cerebrospinal fluid. Amplification and sequence analysis of the hexon and fiber genes identified the virus as HAdV-7-like for both coding regions. Adenoviruses isolated from respiratory and urine specimens were identical and corresponded to genome type 7d2 by restriction enzyme analysis of viral DNA. The isolated strain encodes a unique fiber gene with a 6-nucleotide deletion corresponding to amino acid positions 250 and 251 in the knob region and not previously described for closely related genomic variants of HAdV-7.Conclusions: Adenovirus detection should be included in the diagnostic testing to determine the infectious etiology of fever and/or respiratory symptoms in SLE patients. (C) 2010 Published by Elsevier B.V.