Cytomegalovirus-Induced Polyarteritis Nodosa in a Liver Transplant Recipient

Area of Science:

• Nephrology
• Transplant Surgery
• Infectious Diseases

Background:

• Polyarteritis nodosa (PAN) is a systemic necrotizing vasculitis.
• Hepatitis B virus is a known cause of PAN.
• Cytomegalovirus (CMV) is a common opportunistic infection in transplant recipients.

Observation:

• A liver transplant recipient presented with acute kidney injury and active urinary sediment.
• The patient was diagnosed with tissue-invasive cytomegalovirus (CMV)-induced PAN.
• This presentation highlights a rare but serious complication post-liver transplantation.

Findings:

• Treatment targeting both PAN and CMV infection led to significant clinical improvement.
• Kidney function normalized, and urinary indices resolved.
• The patient experienced no recurrence of PAN or CMV infection during a 3-year follow-up.

Implications:

• CMV infection should be considered in liver transplant recipients presenting with vasculitis and kidney injury.
• Early and comprehensive treatment can lead to favorable outcomes.
• This case underscores the importance of vigilant monitoring for opportunistic infections in immunosuppressed patients.